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THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

PUBLIC HEALTH SERVICE
 

CENTERS FOR DISEASE CONTROL AND PREVENTION
 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
 

convenes the
 

ADVISORY BOARD ON
 

RADIATION AND WORKER HEALTH
 

VOLUME I
 

The transcript of the Meeting of the
 

Advisory Board on Radiation and Worker Health
 

before Debbie G. Williams, Certified Court
 

Reporter and Notary Public; commencing at 8:30
 

a.m., Wednesday, February 5, 2003, at The
 

DoubleTree Guest Suites, 181 Church Street,
 

Charleston, South Carolina.
 

*************************************
 

DEBBIE G. WILLIAMS, CCR, CVR


CERTIFIED VERBATIM REPORTER
 

2515 Little John Court
 

Cumming, Georgia 30040
 

(770) 886-9814
 
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PARTICIPANTS
 

BOARD MEMBERS
 

CHAIR:
 

PAUL L. ZIEMER, Ph.D., Professor Emeritus


School of Health Sciences
 

Purdue University


West Lafayette, Indiana
 

EXECUTIVE SECRETARY:
 

LARRY J. ELLIOTT
 

Director, Office of Compensation Analysis and Support


National Institute for Occupational Safety and Health


Centers for Disease Control and Prevention
 

Cincinnati, Ohio
 

MEMBERSHIP:
 

HENRY A. ANDERSON, M.D.


Chief Medical Officer
 

Occupational and Environmental Health


Wisconsin Division of Public Health
 

Madison, Wisconsin
 

ANTONIO ANDRADE, Ph.D.


Group Leader/Manager


Radiation Protection Services Group


Los Alamos National Laboratory


Los Alamos, New Mexico
 

ROY LYNCH DeHART, M.D., M.P.H.


Director, The Vanderbilt Center for Occupational


and Environmental Medicine
 

Professor of Medicine
 

Nashville, Tennessee
 

RICHARD LEE ESPINOSA
 

Sheet Metal Workers Union Local #49
 

Johnson Controls
 

Los Alamos National Laboratory


Espanola, New Mexico
 

MICHAEL H. GIBSON, President


Paper, Allied-Industrial, Chemical, and Energy Union


Local 5-4200
 

Miamisburg, Ohio
 
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MARK A. GRIFFON, President


Creative Pollution Solutions, Inc.


Salem, New Hampshire
 

JAMES MALCOLM MELIUS, M.D., Dr.P.H.


Director, New York State Laborers' Health and Safety


Trust Fund
 

Albany, New York
 

WANDA I. MUNN, Senior Nuclear Engineer (Retired)


Richland, Washington
 

ROBERT W. PRESLEY, Special Projects Engineer


BWXT Y-12 National Security Complex


Oak Ridge, Tennessee
 

GENEVIEVE S. ROESSLER, Ph.D.


Radiation Consultant
 

Professor Emeritus
 

University of Florida


Elysian, Minnesota
 

AGENDA SPEAKERS
 

MS. MARTHA DiMUZIO, NIOSH


MR. RUSH HENSHAW, NIOSH


DR. JAMES MELIUS
 

DR. SERGIO BUSTOS, SRSHES Chair
 

STAFF/VENDORS
 

CORI HOMER, Committee Management Specialist, NIOSH


DR. JAMES NETON, NIOSH


TERESA ROBINSON, Writer/Editor


DEBBIE G. WILLIAMS, Certified Verbatim Court Reporter
 
 

4 

I N D E X
 

VOLUME I
 

February 5, 2003
 

REGISTRATION AND WELCOME


 Dr. Paul Ziemer, Chair ................... Page 5


Mr. Larry Elliott, Executive Secretary.... Page 7
 

REVIEW AND APPROVAL OF SUMMARY OF CLOSED SESSION
 

MEETING 10 .................................. Page 10
 

PROGRAM STATUS REPORT 


Ms. Martha DiMuzio, NIOSH............... Page 10


Dr. Jim Neton, NIOSH ................... Page 25


Mr. Richard Toohey, NIOSH .............. Page 29
 

IREP LATENCY ADJUSTMENT
 

Mr. Russ Henshaw, NIOSH ................ Page 60
 

IREP SCIENTIFIC ISSUES WORKGROUP REPORT
 

Dr. James Melius, Chairperson .......... Page 95
 

SAVANNAH RIVER SITE HEALTH EFFECTS 


SUBCOMMITTEE ACTIVITIES
 

Dr. Sergio Bustos, SRSHES Chair ........ Page 132
 

BOARD DISCUSSION/WORKING SESSION


Review Process of Dose
 

Reconstructions.......................... Page 150
 

Mr. Hans Behling ........................ Page 225


Ms. Denise Brock ........................ Page 231


PUBLIC COMMENT PERIOD 


Mr. Richard Miller....................... Page 245
 
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P R O C E E D I N G S


 8:30 a.m.
 

DR. ZIEMER: Good morning, everyone. This
 

is the eleventh meeting of the Advisory Board on
 

Radiation and Worker Health. I'm Paul Ziemer,
 

Chairman of the Advisory Board. The Board members
 

are seated here at the table before me, and we're
 

not going to introduce them individually. You can
 

identify them by the placards in front of each
 

individual. 


I would like to indicate for the record that
 

as best we know at the moment, Mike Gibson will be
 

unable to be with us for this meeting. It is our
 

understanding that Henry Anderson will be -- I'm
 

sorry, I said Mike Gibson. It's Leon, isn't it,
 

Leon Owens will be unable. I'm sorry. I hadn't
 

heard that Mike wouldn't be, so maybe Mike will be
 

joining us shortly. Leon Owens will be unable to be
 

here for this meeting. It is my understanding that
 

Henry Anderson will be joining the Board just a
 

little later. There was a conflict that will cause
 

him to arrive late. 


I'd like to remind all of those in
 

attendance today, Board members, as well as staff
 

members from the various agencies, and members of
 
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the public, to register your attendance with us in
 

the registration book that's at the table near the
 

entrance. If you are a member of the general public
 

and wish to address the Board during the public
 

comment period, we ask that you sign up to do so. 


There is a sign-up sheet for commenting during the
 

public comment period, and that sign-up sheet is
 

also on the table near the entrance.
 

There are a number of handouts on the other
 

table in the rear of the room that includes copies
 

of today's Agenda, copies of Minutes of some of the
 

past meetings, and other documents that relate to
 

the presentations that we will have today, so please
 

avail yourself of those materials on the table.
 

We will proceed with the Agenda pretty much
 

as its there. There will be some shifting on the
 

times, as needed, depending on the length of
 

presentations and the Board discussion periods, but
 

in general we will proceed with the Agenda as
 

indicated. 


I would like to point out that originally a
 

month ago when this meeting was confirmed there had
 

been the intent that at this meeting the Board would
 

discuss the provisions of the -- what we thought was
 

the -- going to be the materials in the Code of
 
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Federal Regulations dealing with the Special
 

Exposure Cohorts. That material has not yet
 

appeared in the Federal Register and thus, it cannot
 

be included today as part of our discussion, and the
 

Board members are already aware that that item has
 

been removed from what was the original draft
 

Agenda. The revised Agenda was, of course, on the
 

web site and was promulgated accordingly.
 

I'm going to now turn the mike, or a mike
 

over to Larry Elliott, our Executive Secretary. And
 

Larry has some additional comments before we proceed
 

in the Agenda.
 

MR. ELLIOTT: Thank you, Dr. Ziemer. I just
 

wanted to welcome the Board to Charleston. I hope
 

you find this city to be very interesting, and it is
 

a very exciting city, so I hope you have some time
 

to spend walking through the streets here and enjoy
 

it. 


As Dr. Ziemer said, the Notice of Proposed
 

Rulemaking on additions to the Special Exposure
 

Cohort has not gone completely all through the
 

clearance process, and thus, we have not been able
 

to put it into the Federal Register for public
 

comment. We hope to see that very soon. And
 

tomorrow we will have to take up in the Board's
 
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housekeeping items your agendas for when we can meet
 

to discuss that.
 

On your Agenda today we have a few -- a
 

different -- a couple of different people to -- for
 

you to get to know. I know you've met Martha
 

DiMuzio in the past. Dave Sundin, who traditionally
 

and regularly gives the Program Status Report to you
 

all, is back home in Cincinnati minding the store. 


And Martha DiMuzio is here today, she'll be giving
 

that Program Status Report to you. She's also
 

critical to today's and tomorrow's discussion on the
 

procurement and -- and task order development, so
 

that's why I asked her to be here today. 


And with that, I think I'll turn it back to
 

-- to Dr. Ziemer.
 

DR. ZIEMER: Thank you, Larry. 


You'll notice that the next item on our
 

Agenda is the Review and Approval of Draft Minutes
 

of Meeting 10. What I propose that we do is that we
 

address only the -- what we might call the Minutes,
 

it's the summary of the closed session, which was
 

the executive session. The Minutes of those are not
 

available to be made public, but the summary of the
 

closed section -- or closed session can be made
 

public, and is in the book and we will act on that. 

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The actual Minutes for the open portion of the
 

meeting have been, or are being distributed, and
 

they're rather lengthy. In fact, let me ask: Have
 

they been distributed? Or they will be today
 

sometime, if they're not already.
 

MR. ELLIOTT: I don't see Cori here right
 

now, but I -- I know she's having the copies made.
 

DR. ZIEMER: In any event, those Minutes are
 

thirty-some pages long, and I'm not going to ask you
 

to glance on them and approve them forthwith. We
 

will delay the action on those Minutes till tomorrow
 

morning. I know you all were wanting to have
 

something to do this evening, and that will -- that
 

will occupy your time. 


So without objection, let's simply move to
 

the summary of the closed section -- closed session. 


It's in the tab that says: Draft Minutes/Meeting
 

10. That summary is very brief. It indicates who
 

was in attendance, what the items discussed were,
 

and when the meeting adjourned. And I have -- I
 

have approved these in the sense that I have to
 

certify that to the best of my knowledge they are
 

accurate, but I would entertain a formal motion to
 

approve these by the Board.
 

DR. ANDRADE: I would like to move that the
 
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Minutes, as written, be approved.
 

MR. PRESLEY: Second.
 

WRITER/EDITOR: I'm sorry. Who seconded?
 

DR. ZIEMER: Second by, okay, Robert
 

Presley, and everybody can fight over who the
 

seconder is. The record will show that it was
 

Robert Presley. 


All in favor of approval of the summary of
 

the summary of the closed session, say Aye.
 

BOARD MEMBERS: Aye.
 

DR. ZIEMER: Those opposed, Nay. 


(No responses.)
 

And the Ayes have it. Thank you.
 

Let's move down immediately to the Program
 

Status Report. And Larry has already indicated that
 

Martha DiMuzio will make that presentation this
 

morning. 


Martha, we welcome you, and please take the
 

podium.
 

MS. DiMUZIO: Good morning. I just want to
 

welcome everyone again to the Board meeting. And
 

basically what I'm going to be doing is presenting
 

the program information that Dave Sundin has
 

reported to you previously. 


At the last meeting Dave provided
 
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information which showed trends over the last five
 

quarters, and basically what we've done is we've
 

just added data for January. 


What we have done is on January 20th, NIOSH
 

and ORAU went to a new computer system. We switched
 

over from an access data base system that was only
 

used by NIOSH to an SQL system that's being used by
 

both NIOSH and ORAU. Because of that, there have
 

been delays in entering data into the system. We
 

continue to receive information from DOE and DOL;
 

however, it is possible that not all information has
 

been contained. What we've done is we've done our
 

best efforts to make sure that the information that
 

we're providing you is as accurate as possible.
 

Again, DOL has referred over 10,000 cases to
 

NIOSH for dose reconstruction. As was previously
 

reported, we started receiving cases in October of
 

2001. If you look at the number for January, it's
 

314. We believe that number to be a little bit
 

higher, but again, as of right now that was the
 

information that we had, but we are still receiving,
 

on average, 150 to 200 cases per week from the
 

Department of Labor. 


Again, we continue to send a letter to each
 

claimant letting them know that we've received it
 
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and how the dose reconstruction will be proceeding
 

for their claim. Each case is logged into the
 

system, we scan all their documents, and create and
 

maintain a paper file for the system.
 

The majority of the claims involve employees
 

who work at DOE sites, but about 16 involve
 

employment at atomic weapons or AWE facility.
 

Each case file we receive from DOL lists the
 

verified covered sites where the energy employee
 

worked, and in some cases the energy employee worked
 

at several covered sites. We use this information
 

to direct our request for radiation exposure to the
 

appropriate DOE office. We usually are able to
 

issue the request to DOE within two weeks of receipt
 

of the case.
 

If you'll note on requests that -- responses
 

to -- responses from DOE for our requests, in the
 

month of January there is an asterisk there. In
 

December ORAU took over responsibility for receipt
 

of the DOE responses. As I mentioned earlier, with
 

switching over to the new SQL system not all of
 

those responses have been entered into the system,
 

so we didn't feel we could give you an accurate
 

enough number for January; so hopefully at the next
 

Board meeting we'll have an accurate number of the
 
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responses that we received today.
 

At one of the Board meetings it was
 

requested that we provide response information from
 

the particular sites. The sites that are listed
 

here are the seven largest sites for which we've
 

requested information. And this listing represents
 

81 percent of the total requests that we have with
 

the DOE. As you can see, we've broken it down by
 

60, 90, 120, and 150 days. As you're also aware -­

excuse me -- so for those requests that are over 150
 

days we realize the importance of finding out from
 

DOE what the status of that claim is; can you not
 

find the data, have you just not started looking. 


So with ORAU -- excuse me, OCAS being given
 

additional staff, we will start the process of
 

contacting DOE on each of the individual claims that
 

are over 150 days so that we can get the status of
 

that DOE request. 


Another thing is that these numbers should
 

not be used as an indication of the quality of the
 

data that we've received. In many instances, the
 

DOE operating offices that have taken the longest to
 

respond have in fact provided us the most complete
 

information for the claimants. 


A telephone call is -- a telephone interview
 
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is offered to each claimant to permit them to add
 

information which may be relevant to their case. 


The award of our support contract has substantially
 

increased our capacity to conduct the interviews. 


And as you can see, in January alone, we have more
 

than doubled the numbers of interviews that were
 

conducted in the first quarter of 2003. As of today
 

we have conducted interviews with 726 employees and
 

their survivors, and more than 398 interview reports
 

have been sent to the claimants for their review and
 

comment.
 

We currently have 144 dose reconstructions
 

underway. This means that we have received,
 

assembled, and reviewed and evaluated the readily
 

available information pertinent to a claim, and
 

assigned the case to a NIOSH or ORAU health
 

physicist. 


Over the past month OCAS staff concentrated
 

their efforts on reviewing the initial 62 dose
 

reconstructions which were received from ORAU to
 

ensure compliance with established procedures and
 

The Rule. ORAU is currently updating those 62 dose
 

reconstructions to incorporate NIOSH comments, and
 

they continue to work on the additional 82 dose
 

reconstructions. ORAU is also continuing to review
 
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the individual cases to determine if there is
 

sufficient data to complete a dose reconstruction. 


As this process moves forward, more cases will be
 

forwarded for dose reconstruction.
 

This slide here shows that 16 claims have
 

been sent; however, we've actually completed 18
 

right now -- two went out yesterday -- so for 18
 

claims we have completed the draft dose
 

reconstruction report called for in The Rule, and
 

have either forwarded or received a completed OCAS-1
 

form; so then of the 18 cases, 14 have been
 

transmitted back to DOL, along with the complete
 

administrative record for final adjudication.
 

Again, we encourage the claimants to contact
 

us, and they do. The number of phone calls received
 

in OCAS has received substantially each quarter as
 

we receive more and more claims. And we are
 

receiving on average over 100 calls per day.
 

Our web site is a rich source of information
 

on the program, and is an increasing method of
 

communication to others interested in the program. 


We received over 1100 claims-related e-mails and our
 

goal is to respond to each one of them within 24
 

hours. And as you can see, the web site is being
 

used more and more as a method of communication. 

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For our recent accomplishments, on January
 

24th letters were sent to 35 physicians appointing
 

them to the DOE Physician Panels. And we're going
 

to give those individuals approximately a week, and
 

then we're going to contact them to make sure that
 

they're still interested in participating, although
 

we don't view that as an issue since it's been so
 

recent that contact has been made with them.
 

And as you're aware, OCAS had been given an
 

additional 22 positions and we've been working very
 

hard to fill those. And as of -- as of today we
 

have one new Health Physicist on board; we have two
 

coming on board Monday; we have -- I can now update
 

this slide -- as of yesterday afternoon we have
 

three more Health Physicists coming on board March
 

10th, and which changes that two offers made there,
 

that's now been updated. And we have five Public
 

Health Advisors on board who will assist with claims
 

processing, so we think we're -- we're moving along
 

to hopefully move the claims faster through the
 

system.
 

And I thank you for your attention. If you
 

have any questions.
 

DR. ZIEMER: Thank you, Martha. Let me
 

start the questioning, and then Jim will be next. I
 
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just want to ask: On the web site, is anybody
 

tracking the number of hits that the OCAS web site
 

receives overall?
 

MS. DiMUZIO: No, we're not tracking that at
 

all.
 

DR. ZIEMER: Thank you. Jim?
 

DR. MELIUS: I have a couple of questions,
 

and I don't know if Larry, you may want to jump in. 


One is the issue of the DOE request for information. 


Can someone clarify on the situation? There was
 

obviously two that stood out: Idaho and the
 

Savannah River. And what is the situation with
 

those two sites -- are these -- in terms of
 

receiving dose information?
 

DR. NETON: I think I can help.
 

WRITER/EDITOR: Could we get his name?
 

DR. ZIEMER: Jim Neton of NIOSH. 


DR. NETON: Jim Neton from NIOSH. I think 


-- let's see, Savannah River Site has -- has added
 

staff, and in fact I believe we received 100
 

additional completed responses within the last week
 

or so that aren't indicated in that slide. As
 

Martha mentioned, we're switching over our system
 

and we're -- there's a slight lag period updating
 

that data base. 

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Idaho has moved a large number of boxes from
 

their Federal Record Center in Seattle, and added
 

staff. I believe they're working two shifts. I'm
 

not sure of that, but I know they've added
 

additional personnel; are going through the boxes
 

and entering all the information in a data base, so
 

there's going to be a slight lag period while they 


-- they do that, to pull the records out of those
 

boxes, but once they do, we expect that to pick up
 

very rapidly, so in short we're very pleased with
 

the amount of attention that's been paid at those
 

two sites to move things forward.
 

DR. MELIUS: But even -- I mean you have a
 

number of outstanding requests at Savannah River,
 

will they -- do you think the staffing -- so that
 

was a staffing issue, and do you think the staffing
 

is now adequate?
 

DR. NETON: Yes. I -- I can't say that it's
 

adequate. We see a very large increase in the
 

number coming over, like I've mentioned, 100 within
 

the last week or so. And as Martha indicated, the
 

claim responses that come from Savannah River tend
 

to be fairly complete, so that when we do get a
 

response, it -- it -- I'm not saying that a dose
 

reconstruction could be done immediately because
 
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there are other sites of the profile that need to be
 

fleshed out, but in -- in relation to the monitoring
 

results that we received, they are very, very good
 

quality.
 

DR. MELIUS: And you probably explained this
 

last time in the -- yeah, don't go away -- but are
 

you -- are these completed, or initial responses? I
 

mean what if you get sort of cursory information
 

from a site?
 

DR. NETON: Yeah, that's -- that's right. 


These are initial responses. All that Martha
 

presented was that we received an initial feedback
 

from the -- from the DOE. Prior to ORAU coming on
 

board though, we could not even -- we didn't have
 

the time to look at all of them. We did a quality
 

control spot check to make sure we were sort of
 

getting what we needed. ORAU is now going through
 

the process of looking at all of the responses and 


-- and issuing additional requests for information. 


We've particularly done a large number of those
 

recently at the Hanford facility that have gone out. 


We're going to be tracking that and I think you
 

should see this metric change in the next month or
 

so to show an additional, you know, additional
 

feedback on the -- on the responses that we send
 
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subsequent to the initial one.
 

DR. MELIUS: So -- so will you set up a -­

you'll have a tracking system that will cover both
 

the second request and -­

DR. NETON: Yeah, absolutely. In fact, all
 

of that goes in the claimant's file. If we send an
 

additional response, the letter goes in his -- in
 

the claimant's file and is tracked within our
 

system.
 

DR. MELIUS: Okay. So the -- the bigger
 

picture on that: What's the status of the MOU with
 

DOE, because that would appear to be sort of
 

critical if people are not responsive or eventually
 

not responsive.
 

DR. ZIEMER: Larry?
 

MR. ELLIOTT: Yeah, I'll respond to that
 

question. The Department of Energy's Office of
 

Worker Advocacy just put in place a new -- he's an
 

acting director right now, but he will soon have the
 

job is my understanding, Mr. Tom Rollo. I met with
 

him and explained to him some of the issues that we
 

have with some of the operating areas in the weapons
 

complex providing us information. I told him that
 

we really needed to get this MOU in place. He -- he
 

immediately told me he would go wrestle it from the
 
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DOE lawyers, and the next week we got a copy of it,
 

so it had been languishing over there for, as you
 

know, a number of months. We're in the, what I
 

consider the final throes where it's with my general
 

counsel now and -- and their general counsel trying
 

to hammer out the last final details. I hope by the
 

next meeting we'll have an MOU. There's
 

considerable interest in DOE now, I believe, to see
 

this MOU signed and put in place. 


Let me also add that these numbers that you
 

see that we give you in this program report are
 

going to start to become more and more fluid. By
 

that I mean we'll start -- you'll see the DOE/DOL
 

referrals come to us, but we're also going to start
 

subtracting those away that we finished out. We
 

have -- I've established a policy in OCAS where the
 

-- we're working on the first-come are going to be
 

the first served, so each individual claim that has
 

been sent to us from those that are in that category
 

over 150 days of age, we're going to have a very
 

detailed, specific status that when we have a phone
 

call from the claimant we can speak very
 

specifically about the status of that claim, and
 

where it's at, and what it takes to move it to the
 

next step.
 
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Things are picking up speed. I assure you
 

of that. We are seeing movement with -- with our
 

ORAU contractor and in monitoring the DOE submittals
 

on the initial requests. We are going to track, as
 

Jim said, very closely the secondary requests that
 

go out and monitor those. The Department of Energy
 

understands that tracking system will either be a
 

boon or a detriment to them in showing how well they
 

are responding to our requests, so I think -- I
 

think we're moving in the right direction and we're
 

picking up steam as we go.
 

DR. MELIUS: Well, since you mentioned -- a
 

follow-up to that. One is, I think it would be
 

helpful to show similar data from the web site as
 

well as on the -- at the Board meetings on the
 

progress with the time line for the claims that are
 

pending; how many are over a certain number of days. 


And I recognize until the contract was in place it
 

was, you know, very difficult and it probably didn't
 

make sense to do, but -- but I think that would be
 

helpful information for everybody, and it would also
 

then take into account the -- the component of that
 

that's due to whatever the delay might be, whether
 

it's the DOE getting information to you, a site
 

where it's hard to find anybody that has
 
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information, and so forth, so that -- you know, I
 

think it would be very useful information in -- in
 

terms of the accountability and progress of the
 

program. 


And I guess related to that question, it's
 

sort of been stuck around 15 or 14 for a while. And
 

I -- maybe I missed it at the last meeting, but I
 

guess I'm sort of trying to get a sense of what the
 

schedules when you're going to be starting sending
 

more information over to the Department of Labor. I
 

recognize that, you know, a lot of time has been
 

spent getting the contractor in place and up to
 

speed and so forth, but I think it's, you know, the
 

number has been the same for a while, so.
 

MR. ELLIOTT: Sure. Sure. Well, as I hope
 

you understand, we've been putting the machinery
 

together to -- and the full implementation of this
 

program. We're through that phase I think now. 


We're into the next phase, which I -- I would
 

characterize as scaling up, you know, getting -­

getting to the point where our through put needs to
 

be in order to reduce the backlog that we have. It
 

takes time to do these things. Why -- why we're
 

only at 14 or 15, we -- we -- as we told you, we
 

looked at the low-hanging fruit to use those claims
 
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as a mechanism to test the machinery, and put the
 

machinery in place, and make sure it was
 

operational.


 With the ORAU folks meeting our -- our
 

stated expectations of 60 draft dose reconstructions
 

by the end of December, they met that, they actually
 

came in with 62, you know, on January 2nd or so. 


Those 62 are going to be forthcoming very shortly. 


They -- they are going to turn those around to us,
 

in fact, you know, we -- it was a month ago we met
 

and we have, I think, seven -- seven or eight inhouse in our OCAS staff left. All of the new Health
 

Physicists in OCAS will be tasked with doing dose
 

reconstructions themselves as well, to make sure
 

that they understand the process, the procedures,
 

and The Rule that we have in place; show us they can
 

do a few of these as well, as they start reviewing
 

them, so we're going to -- we're going to move
 

forward on a more rapid pace, I assure you.
 

DR. NETON: Yeah, I'd just like to add a
 

couple of comments to that. I think what we -- what
 

-- Larry's correct, and what you're seeing in that
 

initial number of claims that came over were the
 

ones that the OCAS staff actually started on. Our
 

staff is three Health Physicists and we started, I
 
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think, about 25, and Larry's correct, I think we
 

just finished 18, so we have a few more to finish
 

up. But we did select those based on not only low-


hanging fruit, but different types of claims to
 

establish the mechanism for doing them; the manner
 

in which they'd be done. And as soon as the ORAU
 

contractor took over we've been in the process of
 

transferring that approach to them, and they've
 

adopted it, and have maybe 60 or so that we feel
 

fairly closely followed, you know, the -- the way
 

that we started them, so we do expect these
 

additional 60 to be coming over fairly -- fairly
 

quickly. 


DR. ZIEMER: Any additional questions,
 

comments?
 

Okay. Thank you, Martha. 


While we are on this general topic, I'd like
 

to call on Jim Neton and Richard Toohey to also
 

update us on the contractor status and activities. 


Jim, if you'll kick that off and we'll just consider
 

this part of the Program Status Report.
 

DR. NETON: Thank you, Dr. Ziemer. I just
 

have a -- I'm going to talk very briefly and then
 

turn the bulk of this short presentation over to -­

to Dick Toohey. But what -- what we'd like to
 
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address briefly is the status of claimant
 

correspondence; where we are with our -- our sending
 

information to claimant and keeping them updated. 


I'm going to talk about what we have done within
 

NIOSH to initiate that process, and then Dick Toohey
 

is going to discuss after me what ORAU intends to do
 

to communicate their activities to the claimant, and
 

particular to address some of the issues that were
 

raised at the Board meeting last month about
 

transparency, conflict of interest, communication of
 

the claimants as the -- as to how the policy is
 

going to be implemented for particularly conflict of
 

interest.
 

Very briefly, the white boxes you see on the
 

diagram are the -- the letters that NIOSH already
 

have in place and are communicating to claimant. 


There are five individual communications as you see. 


These are formal correspondence, not verbal or
 

anything, these are just on formal letters that we
 

send. 


The first one is the acknowledgment letter
 

that the claimant receives very shortly after we
 

receive the -- the referral from the Department of
 

Labor, and that tells the claimant that we received
 

their claim and in fact that we have issued a
 
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request to the Department of Energy for their
 

exposure information. At that point, now we
 

transfer the claim over to ORAU for the receipt of
 

the DOE information. 


The next step is the claimant will receive a
 

phone interview letter informing them that we have
 

an upcoming interview we'd like to conduct with
 

them. The letter contains the -- it's not exactly
 

the OMB approved script, but it's a summary of the
 

lines of inquiry that we'll be going over, so that
 

they can prepare in their responses. A summary of
 

the phone interview is subsequently mailed to the
 

claimant to allow them the opportunity to review
 

that information and either correct or provide
 

supplemental information at that time.
 

Once the dose reconstruction has been
 

assigned and complete, currently the way it operates
 

is a draft dose reconstruction is sent to the
 

claimant -- and we've done this, as Martha
 

indicated, 18 occasions now -- giving the claimant
 

the draft dose reconstruction the opportunity to
 

provide feedback, and if they concur that the dose
 

reconstruction addressed all of their comments and 


-- and issues that were raised during the interview,
 

the person, the claimant would sign an OCAS-1 form
 
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and return that back to us. 


Once we are in receipt of the OCAS-1 form,
 

then we would issue the final dose reconstruction,
 

forward copies to the Department of Labor and the
 

claimant. 


So that -- that's the current status. We're
 

trying to -- ORAU is trying to integrate into this
 

process, as you see, Dick is going to be addressing
 

briefly the contents -- or the proposed contents of
 

an introduction letter that tells them that ORAU is
 

going to be taking over the dose reconstruction at
 

that point. Currently our claimants, most of our
 

claimants are not aware that ORAU exists as a
 

contractor; they know NIOSH, so we -- we want to
 

flesh that out and inform them a little better as to
 

what the process is. 


I think more importantly, the box on the
 

lower left, the ORAU Dose Reconstruction initiation
 

letter, is going to very informative to the
 

claimant. That is the point at which ORAU will send
 

a letter when they're ready to start the dose
 

reconstruction and assign a person, that the
 

claimant will receive a letter with the biographical
 

sketch, and the ability to comment on the
 

appropriateness of that person doing the dose
 
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reconstruction. Dick's going to flesh that out in
 

the next few slides. 


So I think that's all I really have to say. 


I'll turn it over to Dick and he can discuss the
 

other two boxes.
 

DR. TOOHEY: Okay. Thanks, Jim.
 

Let me talk first about the ORAU introletter. We like to think we're a very well known
 

organization, but we may not always be correct about
 

that, so we decided that an introductory letter goes
 

out that briefly describes the roles and
 

responsibilities of the ORAU team first making it
 

clear that we are a support contractor for NIOSH,
 

who retains responsibility for the process, and then
 

a little information about ORAU and our partners,
 

MJW Corporation and Dade Moeller & Associates. And
 

we haven't actually decided yet, but I'm thinking
 

the easiest way to do that just might be a tri-fold
 

brochure we stuff in the envelope that's kind of
 

similar to the tri-fold OCAS brochure. And really
 

the information on that about the companies would be
 

much the same that's in the disclosure statements
 

and brief corporate histories that are in the
 

Conflict of Interest Plan that's posted on the web
 

page. 

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The important thing we want to get out to
 

the claimant at this point is who should they call. 


We will be assigning a claim manager who is a Health
 

Physicist, and a claim specialist, a support person
 

not necessarily a Health Physicist. We have four of
 

each, and we're assigning them to the four
 

Department of Labor regions and they will be the
 

principal point of contact with us for a claimant;
 

so a claimant, any question, any issue, whatever,
 

you know, this is the person to call and those
 

people will be responsible for having the updated
 

version of NOCDUS (ph) at their fingertips, know the
 

status of that claim. They will also serve as sort
 

of a technical manager just shepherding the claim
 

through the interview and dose reconstruction
 

process, and any glitches that come up, any problems
 

we may have, it's their job to be aware of those,
 

manage them, perhaps assist a dose reconstructor who
 

needs to grab another piece of information for
 

whatever to complete the dose reconstruction and so
 

on. We'll include our 800-number, which is up,
 

operational and staffed, and we're -- we're getting
 

calls. It's only about 10 or 20 per day now, it's
 

not at the NIOSH numbers, but starting to get used. 


But also, what to expect, and just a little
 
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reiteration of the process. So after this letter,
 

the next thing the claimant should expect is the
 

dose -- I'm sorry, the telephone interview letter. 


And reiterating, you always have the chance to
 

supply more information. Anything you have you want
 

to send in, by all means, feel free to do so. It
 

will go into the administrative record. Then when
 

the telephone interview is completed and the
 

client's received and approved, or at least not
 

contested, the report of the telephone interview
 

then moves to dose reconstruction, and then they
 

will receive the draft dose reconstruction with the 


OCAS-1 form and all that.
 

Okay. Then after the telephone interview is
 

completed and they got back, then when the claim is
 

ready to actually move into dose reconstruction,
 

we've got the DOE exposure information we're going
 

to get; the telephone interview is complete, as I
 

said, and it's ready to go, the next letter to the
 

claimant is a status report simply saying okay, your
 

claim is actually moving into the actual, physical 


-- or -- well, yeah, it is a physical process of
 

dose reconstruction. The key point here is the
 

Health Physicist who is doing the dose
 

reconstruction, and the claimant will be invited to
 
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offer an objection of any sort to this person. 


There may well be a perceived or actual conflict of
 

interest situation which, despite our best efforts,
 

we're not aware of that the claimant may know about;
 

personal contact, whatever. And we want to give the
 

claimant that opportunity to object to this person;
 

if they do not, then the -- say within a reasonable
 

time frame, two weeks or so, and again by e-mail, by
 

the 800-number, by a phone call directly to their
 

claim manager, whatever method they want to use, we
 

don't get a request for a different Health Physicist
 

being assigned, then we will proceed with the actual
 

dose reconstruction at that point. And then the
 

paper trail goes back to NIOSH as we supply the
 

draft dose reconstruction for NIOSH for review and
 

approval. Then it gets sent -- the draft gets sent
 

to the claimant with the OCAS-1 form. 


Okay. Let me ask, any questions at this
 

point on the proposed letters?
 

DR. ZIEMER: Rich, I'd like to ask a
 

question about the -- let's say the -- I'll call it
 

the issue of requesting a different reviewer. Have
 

you developed some parameters on which you will
 

decide whether the concern is a valid one? It seems
 

to me that one could, in some cases, exhaust every
 
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possible dose reconstructor for some facetious
 

claims. How are you going to decide what will be a
 

valid objection?
 

DR. TOOHEY: Well, we want to concentrate on
 

conflict of interest issues. We certainly plan, and
 

have hoped to eliminate, you know, conflicts from
 

having worked at the same site, or -- or this, that
 

and the other, things which we're all aware of, but
 

there may be other things. I don't think the
 

claimant would necessarily have a basis for judging
 

the technical competence of this individual,
 

although they'll have -- they'll have the biosketch, but we don't envision that as an issue. We
 

think if the claimant has a -- a valid reason or
 

concern, whatever that may be, we will try our best,
 

but you have hit a key point, even though we've got
 

a whole bunch of Health Physicists, it's conceivable
 

we could run through the whole thing. A claimant
 

could take the position that they don't want anybody
 

who ever worked for DOE in any way, shape, or form,
 

touching their dose reconstruction. And that's
 

simply not -- not feasible to accommodate that, but,
 

you know, we'll do our best to work with, and find
 

an acceptable person. It's going to be easier in
 

the early stages. As time goes on and we have all
 
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our resources fully committed, we'll necessarily
 

lose a little flexibility. I think it's also fair
 

to apprise the claimant that if you do want another
 

Health Physicist assigned, well, that's going to
 

delay things another couple of weeks perhaps. Now,
 

you know, if the claim has been in for a year-and-ahalf maybe that's not a big deal, maybe it is. But
 

we -- to answer your question though, we do want to
 

concentrate on the conflict of interest issue.
 

DR. ZIEMER: Roy DeHart has a question.
 

MR. DeHART: Dick, if I understood
 

correctly, you'll have four teams to cover all the
 

claimants?
 

DR. TOOHEY: Correct. They're -- they're
 

very similar to the Public Health Assistants NIOSH
 

is using.
 

MR. DeHART: Has anyone modeled what the
 

potential number of phone calls are going to be as
 

you approach a thousand per team? I'm -- I'm
 

serious, because in some of the research work we've
 

done, we found people will call two and three times
 

a day. 


DR. TOOHEY: We simply anticipate it will be
 

similar to what NIOSH is seeing now. We've got, I
 

think, two full-time 800-number operators. We're
 
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splitting the shifts so one works 8:00 to 4:00, the
 

other noon to 8:00, so we -- we'll have that line
 

covered 8:00 a.m. to 8:00 p.m. Eastern time. Simple
 

questions, the phone operators may answer; something
 

more detailed, they'll transfer it to the
 

appropriate claim specialist.
 

MR. DeHART: That's my concern -­

DR. ZIEMER: Rich -- excuse me. Rich, would
 

you move your mike up a little bit? I think people
 

in the back are having a little trouble hearing you.
 

DR. TOOHEY: I'm sorry. Is that better?
 

DR. ZIEMER: We'll see how it goes.
 

DR. TOOHEY: Okay. Thank you.
 

MR. DeHART: My concern is bombarding the
 

four -- four teams with trying to simply address
 

questions that are coming in, and without time to
 

really be doing what they're supposed to be doing.
 

DR. TOOHEY: But that is what they're
 

supposed to be doing. See, that -- that's the
 

point. In discussions with NIOSH, we found some of
 

the pressurization in the system they had was that
 

handling these phone calls and dealing with the
 

claimants was sort of an additional duty to what
 

their folks were specifically assigned to do, and we
 

said well, wait a minute, let's get people whose
 
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specific job is to interact with the claimant, so
 

they don't -- they're not doing the dose
 

reconstructions; they're not doing the data
 

retrieval; their job is to be there and work with
 

that claimant.
 

MR. ELLIOTT: If I -- if I could make a
 

comment. Your point is very well taken with us, 


Dr. Anderson -- DeHart, I'm sorry. I was thinking
 

about Henry. Our Public Health Advisors are -- are,
 

you know, we're setting them up to be the champion
 

for the claimants, and to be there as the first
 

point of contact, the NIOSH point of contact, so
 

they're going to be introduced that way to each
 

claimant. Each claimant is going to know who their
 

Public Health Advisor is at NIOSH, that's their
 

primary point of contact. The ORAU folks,
 

complimentary to our Public Health Advisors, are
 

these claims managers and claims specialists. So
 

the way I think I see this working is our Public
 

Health Advisors are going to, you know, work close
 

in hand with their counterparts in the ORAU team. 


Once the claim -- the individual claim has
 

transgressed to the point of moving into dose
 

reconstruction, our Public Health Advisor is going
 

to know who over at ORAU knows where that's at;
 
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what's the status; they're going to know who has
 

been assigned as the dose reconstructionist, and be
 

able to talk collectively about the status of that 


-- of that claim. So we're trying to set it up so
 

that a claimant has not only a NIOSH point of
 

contact, but an ORAU point of contact. They can
 

call -- choose whichever one they want to talk to
 

about their claim at any given point in the process,
 

and whoever they speak to will be able to pull up -­

and you've seen our -- our -- what's called NOCDUS,
 

our tracking system. Whoever they talk to, whether
 

it's me, or the Public Health Advisor, or the ORAU
 

team member, they're going to have the latest
 

information on status to speak to about that claim
 

for the claimant. So I hope this works; I think -­

I think it will, but very concerned as you -- as you
 

point out, the case load for some of these people,
 

some of these teams. And -- and what we've seen to
 

date is we get a lot of phone calls, but it's a
 

minority, it's a vocal minority that we're dealing
 

with. The majority of the claims that we have, we
 

don't have any contact. People haven't started
 

calling us yet, that's not to say that they won't. 


But right now that's what we see happening, and we
 

also see different trends with different District
 
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Offices within the Department of Labor. The
 

Jacksonville Office and the Cleveland Office carry a
 

-- a higher caseload than the -- than the Denver and
 

the Seattle Office right now, so we're going to put
 

our resources to bear on those two offices, and
 

we'll shift as we need to as time and things change.
 

DR. ZIEMER: We have Robert next, I think,
 

then Richard, and then Tony.
 

MR. PRESLEY: Robert Presley. 


Dr. Toohey, the -- what they will need is
 

their case number when they call the 1-800-number,
 

that's number one?
 

DR. TOOHEY: Correct. That's the key access
 

parameter, but again, we can search the data base,
 

you know, name, Social Security number, or work
 

site, whatever. We -- we -- and we're confident we
 

-- we can find the record.
 

MR. ESPINOSA: There's been complaints about
 

the summary, the letter summary not reflecting what
 

the interview was, the total interview. And I think
 

last meeting we discussed that there was not enough
 

space on the computer program. Has that been
 

addressed?
 

DR. TOOHEY: I'm not sure it's been
 

completed, but it's certainly in the process. As
 
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part of the roll-out of the new NOCDUS system on the
 

SQL server there's also a new CATI, Computer
 

Assisted Telephone Interview, data base system which
 

has a lot more room and space on them, so -­

MR. ELLIOTT: I would like to speak to that,
 

too, though.
 

I'm sorry, Jim. Go ahead.
 

MR. NETON: I was just going to say that we
 

have not fixed the program, but we are focusing on
 

the review process now and making sure that all that
 

information is there, so none, to our knowledge,
 

have gone out that have been truncated because of
 

the space issue. We take that out of the comment -­

the response field and move it down into the
 

comments field, so it's all there. And eventually
 

it will be fixed in the program itself.
 

MR. ESPINOSA: And the letter is going to
 

reflect everything that was said on the interview?
 

MR. NETON: Well, I mean I don't know that,
 

you know, if it's a three-hour interview that we're
 

going to have -- it's not a transcript, that's not
 

the intent of it, but it will reflect everything
 

that has to bear on the dose reconstruction itself. 


MR. ELLIOTT: When you say the letter,
 

I think what you're referring to Rich, is
 
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the draft interview report. And the reason
 

why we give that back as a draft to the
 

person who was interviewed is to give them
 

an opportunity to make sure that they feel
 

that everything was there that they wanted
 

to see there, so they have the opportunity
 

at that point to write in sentences or
 

paragraphs that they want to see added that
 

-- that they feel they spoke to in the
 

interview, but didn't get captured. So
 

it's, you know, it's a -- it's a redundant
 

system; it's a -- it's a secondary attempt
 

to -- to make sure all the information is
 

captured that the claimant feels is
 

important. We -- we've taken another look,
 

another review at our interview process, and
 

as Jim says, on some of the early interviews
 

our process was for certain questions we had
 

a certain character field limitation, and
 

once you exceeded that, you were to drop
 

down into the comment field, which is an
 

unlimited space. And that was -- that was
 

happening, but we were still getting, you
 

know, some people were looking at that and
 

seeing that some sentences seemed to be
 
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truncated in -- in their original responses. 


We didn't lose the information, we just
 

didn't fully and accurately portray it back
 

in the draft report to the individual, and
 

that gave them an opportunity to respond to
 

us. So I think we've -- we've tended to
 

that issue and we've made the corrections
 

necessary.
 

DR. ZIEMER: Tony.
 

DR. ANDRADE: Okay. Moving beyond the
 

activities that might take place after an issue with
 

conflict of interest comes up and is perhaps
 

resolved, please refresh my memory, Larry, or
 

Richard, at what point does the claimant actually
 

have the final opportunity for recourse to a -- a
 

review of their dose reconstruction as -- as was put
 

into the original legislation?
 

DR. TOOHEY: Well, there's two steps as I
 

understand, although Larry Elliott may be better. 


They get the Draft Dose Reconstruction Report and
 

the OCAS-1 form; signing the form does not mean I
 

agree with the dose reconstruction, simply I have
 

nothing more to add at this stage. And then there's
 

also the appeal process with the Department of
 

Labor, should the claim be denied.
 
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DR. ANDRADE: So it -­

MR. ELLIOTT: Does that answer your 

question? 

DR. ANDRADE: Once the Department of Labor 

receives the -- is it the final?
 

MR. ELLIOTT: Once the Department of Labor
 

receives the final dose reconstruction from us and
 

the full administrative record, at that point they
 

will render a decision, a recommended decision. At
 

that point, on the recommended decision, the person
 

has a -- has an opportunity to contest that
 

decision, to appeal it.
 

DR. ANDRADE: Thank you.
 

DR. TOOHEY: Okay. If we move on -­

DR. ZIEMER: Okay, Rich -- yeah, go ahead
 

then. You have another slide.
 

DR. TOOHEY: Well, I think it's just one
 

more. Okay. As I promised at the last meeting in
 

Cincinnati, our project web page is up. The URL is
 

www.oraucoc - Cincinnati Operational Center - .org. 


The biographical sketches of the Health Physicists
 

performing dose reconstructions are posted on there. 


There were two of them up yesterday morning; I'm
 

sure there are more now and we'll continue, even as
 

we speak. We're concentrating on the people who
 
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have already been involved in performing dose
 

reconstructions, but eventually we'll get everybody
 

out there. 


And incidentally, I've distributed, you
 

should have in your package, the latest measles
 

chart. I know Dr. Roessler, in San Antonio, wanted
 

to know how many Health Physicists we had working
 

and who they were. Well, you now have that chart. 


There's 94 names on that chart with their
 

qualifications, not all are involved in dose
 

reconstructions, some are data retrievers and
 

analyzers. The claims managers are also listed on
 

there. I'm listed on there, also. I don't know if
 

I will ever actually get to do a dose reconstruction
 

myself, but I -- I still plan to someday. The -­

there are five more people I'm aware of we'll be
 

bringing in. And just remember, that roster is a
 

fluid document, people will be coming on and -- and
 

dropping off of our roster. The -- and the majority
 

of folks on there, certainly listed under MJW
 

Corporation, are part-time dose reconstructors, and
 

will be given a file to perform the dose
 

reconstruction and sending it back in. For ORAU,
 

several consultants are listed, Peter Groer,
 

University of Tennessee; Dick Griffith, Nancy
 
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Daugherty, are also part-time consultants on this
 

project, but most of the other folks listed on there
 

are full-time assigned. Only Dade Moeller &
 

Associates are full-timers, for example. So I hope
 

that satisfied that one request. 


The disclosure forms are also being scanned
 

in and posted on the web page. We have also, we
 

will have more information about the project, and
 

again list our 800-number and the links to other
 

sites. And again, that's also a work-in-progress,
 

but it is up, or at least it was yesterday, I
 

haven't tried today.
 

Okay. I think that's all I have.
 

DR. ZIEMER: Okay. We have -- stay there,
 

Rich, for a few minutes.
 

Jim, you have a question?
 

DR. MELIUS: Actually, my question goes back
 

to the earlier presentation. I've had time to
 

scribble some numbers, and I just had some questions
 

about what was presented. Regarding the DOE
 

response and whose -- the numbers are not important
 

necessarily to answering the question, but the
 

reason I'm asking it, if I do this correctly, this
 

table that you showed with the list of the sites,
 

there's a selected number of sites, I assume it's
 
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the ones with the most requests out. You cover
 

roughly 6800 -- you actually have a total of 8400
 

requests out to DOE as of the end of December for
 

information, so there's roughly 1600 that are
 

missing from this table. If the numbers are right,
 

you've received requests -- response back, about
 

4800 total, of which 4500 are left in this table,
 

again, roughly, which is a low percentage, if those
 

numbers are right and they may not be, it's roughly
 

300 out of the 1600 requests that responded to them,
 

so I guess my question is: What other sites are
 

there problems with? It would seem to me that, you
 

know, are these two the ones that stand out in terms
 

of this, and I mean are there delays at other sites?
 

I don't -­

DR. ZIEMER: This, presumably is over 80
 

percent of the total requests to the DOE, is that
 

correct?
 

MR. ELLIOTT: That's correct.
 

DR. MELIUS: Yeah, that -­

DR. ZIEMER: That's the DOE, but not to the
 

other contractors, right?
 

MR. ELLIOTT: That's correct. 


DR. ZIEMER: These are the DOE sites on
 

here?
 
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MR. ELLIOTT: What's not on here is like a
 

Nevada test site. They have a very good response
 

with us, but very -- not a -- not a large number of
 

claims. I don't know if Jim or Martha could help me
 

out here in the other sites, but these are the -­

are the main sites that we have the largest numbers
 

of claims represented for.
 

DR. MELIUS: And I guess my question is not
 

even knowing which sites are involved or who's
 

responding or whatever, it's that you do have a
 

tracking system in place to deal with all the sites,
 

and then it would seem to me if we identify sites
 

that are lagging, even though they're not a large
 

number of claims out there, and look into them and
 

see what -- what's the problem, or -­

MR. ELLIOTT: Right. And that's exactly
 

what we've done with -- with INEEL and Savannah
 

River Site. They have been traditionally our
 

poorest performers as far as responding, but when
 

they respond the quality of the information they
 

give us is very, very good, compared to some other
 

sites where they are quick to respond, but the
 

quality is not what we're seeking. 


DR. MELIUS: And then I think over time one
 

could then sort of look at, well, the second
 
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request, so what's the total time it takes to get an
 

adequate amount of information from the site. I
 

think as long as you have a system in place to do
 

that, I also think that ought to be, you know, sort
 

of a transparent system once it's up and running so
 

people know and the claimants can tell -­

MR. ELLIOTT: Sure.
 

DR. MELIUS: -- you know, what's the average
 

amount of time, what's, you know, is their claim
 

unusual for some reason.
 

MR. ELLIOTT: As we tracked and monitored
 

these statistics and we saw INEEL and Savannah River
 

continually, you know, late in -- in responding to
 

us, that's when we went back to DOE and we said what
 

gives here, why -- why is this going on. And
 

through -- there's a -- I forget the name of this
 

group, but there's a records group that meets on a
 

weekly basis and they talk about these things, and 


-- and it came to light that there was a
 

misunderstanding at Hanford and that was -- or at
 

INEEL, and that was causing some of the problems. 


And so once we got them on track with what we were
 

really wanting, they started providing it. And then
 

Savannah River, we found out that they were just so
 

short staffed, and we applied some pressure, and
 
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they got some more staff. So we're using these
 

statistics that way, to go back and pressure where
 

we can.
 

DR. MELIUS: Just to follow up. I mean I
 

think as this program gets more complex, and
 

particularly your working now through a contractor,
 

having this sort of a system in place and making
 

that information available, it's going to become
 

even more important. Is now a time -- I mean you
 

know internally what's going on, I'm sure, Jim, and
 

deal with it, but as it gets sort of spread out and
 

the numbers get bigger, it's going to get more.
 

DR. ZIEMER: Okay. Gen Roessler.
 

DR. ROESSLER: Thank you for this list of
 

people involved in the team, which we had asked for
 

some time ago. It does give us a chance to, at
 

least on a preliminary way, evaluate the quality of
 

this team, and I've looked through the list and I'm
 

really impressed.
 

MS. MUNN: It's impressive.
 

MS. ROESSLER: It's very impressive. I
 

think in particular, this is not the only measure,
 

but there are a high percentage of people under the
 

CHP column, which is Certified Health Physicists,
 

which speaks to the quality of the team, so I -- I
 
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appreciate this.
 

DR. ZIEMER: Thank you. 


Other comments, questions? Yeah, Larry.
 

MR. ELLIOTT: Before you step down, Dick, in
 

the -- am I right in the next couple of weeks we're
 

going to see some assignments for dose
 

reconstruction to occur? We've got a number of
 

CATI's done, a number of interviews completed, and
 

we're going to see ORAU start making assignments of
 

dose reconstruction, and that's why it's important
 

for -- for your integration letter -- introduction
 

letter to get integrated into this -- this process,
 

so.
 

DR. TOOHEY: Correct. And as you know, the
 

drafts of those letters have been going back and
 

forth between us and OCAS, and I think we're very
 

close to agreement on the final wording and those
 

will be routinely going out.
 

MR. ELLIOTT: So the Board and the public
 

understands, what's happened up to this point is for
 

the 62 that ORAU took on, and you know, to make sure
 

that -- that their folks understood the process and
 

we were using the right methods, we did not approach
 

the individual claimants with who is doing the dose
 

reconstruction, so we're going to have a two-part
 
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process here; for those 62, they're going to get a
 

letter from ORAU or from us, I'm not sure which yet,
 

that says here's your draft dose reconstruction
 

report and here's who worked it up for you, your
 

dose reconstructionist was, and here is there biosketch; if you have an issue with this, make it
 

known now. And then from, you know, in the next
 

couple of weeks as we start assigning dose
 

reconstructionists to claims, before the work starts
 

a letter will go out from ORAU introducing the dose
 

reconstructionist and seeking any objection.
 

DR. TOOHEY: Yes. If you'll recall, those
 

62 were -- I don't even call them draft dose
 

reconstructions, but rather, test dose
 

reconstructions and they were simply to be delivered
 

to NIOSH for review. Are we doing it right? And
 

generally, the answer was yes, and we've reviewed
 

the comments and responded to that, tweaked our
 

procedures a bit as needed, so we're -- we're ready
 

to start cranking on these things.
 

DR. ZIEMER: Okay. Roy, and then Jim.
 

MR. DeHART: A simple question. Once the
 

models are complete, could those be e-mailed to us
 

so that we can just have a look at them and know
 

what to expect should we get any questions?
 
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DR. TOOHEY: The model letters?
 

MR. DeHART: The model letters, yes.
 

DR. TOOHEY: Sure. Yeah.
 

DR. ZIEMER: The same comment?
 

DR. MELIUS: That was the same comment.
 

DR. TOOHEY: We'll put them on the web site
 

whenever it will be. Fine.
 

DR. ZIEMER: So someone will make sure that
 

-- staff will be make sure that occurs. Thank you.
 

Other comments? Other questions for 


Dr. Toohey?
 

DR. ZIEMER: Yes. Mark?
 

MR. GRIFFON: I'm not sure if this is
 

appropriate for now, but I was curious just the
 

status of getting your program developed, you know,
 

the procedures that are under development; check
 

bases that are under development; some that are
 

completed, whatever; and if there was a listing of
 

those things that were either in draft or finalized.
 

DR. TOOHEY: There's a listing of documents,
 

including procedures, we supply that with our
 

monthly report to NIOSH. I can certainly get you an
 

update on that. And -- and incidentally, I should
 

comment on the -- the test dose reconstructions. 


They will not be considered final, and then sent to
 
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Labor until the procedures have been finalized and
 

approved, so that, of course, I'll get a final
 

review stage to make sure that we didn't miss
 

something in accommodating those, but as they move
 

into the final dose reconstruction step, they will
 

be on that. 


The internal dose reconstruction procedure
 

is currently with our document manager for review
 

and approval. That's pretty close to finished. 


She's working with Grady Calhoun, who's our NIOSH
 

contact for document approval on that one. The
 

external dose reconstruction procedure, we've got a
 

draft in for review now. It may another week or two
 

before that's finalized. 


DR. ZIEMER: So, Rich, you will have a some
 

sort of a compilation of approval procedures and -­

DR. TOOHEY: Yeah. Well, and we -­

DR. ZIEMER: -- perhaps that can be made
 

available -­

DR. TOOHEY: -- we can certainly put the -­

DR. ZIEMER: -- as well.
 

DR. TOOHEY: We can put the list on the web
 

page, and I don't see any reason not to put the
 

procedures out there if you would like that, also.
 

DR. ZIEMER: I think there is a sentiment
 
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for having those made available.
 

room. 

DR. TOOHEY: 

DR. ZIEMER: 

DR. TOOHEY: 

Okay. 

Thank you. 

We've got plenty of server 

DR. ZIEMER: Other comments? Mike Gibson. 

MR. GIBSON: Just one concern for the 

record, it's not really relevant to, you know, I
 

know that you're working on the conflict of interest
 

and everything else, but just running through the
 

list, I am somewhat concerned with this one -- of
 

this shallow pool of Health Physicists and internal
 

dosimetrists, there's going to be enough left at the
 

sites to do the current work to make it accurate to
 

-- to send forward to this dose reconstruction
 

process.
 

DR. TOOHEY: Yeah.
 

MR. GIBSON: I notice here there's six to
 

eight from Mound that left the site, and went to
 

work for ORAU, or one of their subs.
 

DR. TOOHEY: And of course, that's because
 

Mound is, as you know, closing down. We've picked
 

up refugees from Fernald. We're competing with
 

NIOSH for the same people, they're adding to their
 

staff, as so are we. And -- but actually, we think
 
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the solution to that is really what we've developed,
 

and it gives us a lot of flexibility, is to have the
 

majority of dose reconstructions done by part-timers
 

who are acting as independent consultants to ORAU or
 

one of our subcontractors. And after, you know,
 

we've got a huge bolus to work through on the
 

backlog, but then as things slow down after that,
 

you know, those people would be not as busy as
 

previously; but, no, I agree with you, it is an
 

issue. There's -- there's a limited pool of
 

competent dosimetrists out there.
 

DR. ZIEMER: Tony has a comment.
 

DR. ANDRADE: I'd like to respond to Mike's
 

comment by informing the Board and visitors here
 

that normally the folks that do respond, at least
 

the folks that I'm familiar with that do respond to
 

requests for raw data on doses, on situations, on
 

facility information, and so on and so forth, are
 

not necessarily Health Physicists at all. Those
 

folks are usually document specialists who have been
 

trained in handling nuclear facility documents, who
 

have also been trained on the job for the most part,
 

on some aspects of health physics, such that they
 

provide the appropriate types of dose information;
 

for example, on a yearly basis, rather than a
 
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committed effective dose equivalent, which is what
 

they're interested in using for dose reconstruction,
 

so they're like ARMA (ph) members, and that sort of
 

thing.
 

DR. ZIEMER: So they are not dose
 

reconstructionists, is what you're saying? 


DR. ANDRADE: Exactly.
 

DR. ZIEMER: And may not be competing with
 

this pool. Thank you for that comment. DR. TOOHEY: 


Okay. Well, I -­

DR. ZIEMER: Go ahead.
 

DR. TOOHEY: I was just going to say I
 

understood Mike's question to refer to we're
 

stealing health physicists from the operational
 

dosimetry departments at the sites to work on this
 

project, and well, if people want to vote with their
 

feet, then you know, I have no objection.
 

MR. ELLIOTT: One more comment that we've
 

received at OCAS that I would like to share with the
 

Board and the public here, and that's a comment
 

that's come to us about the need to be aware of
 

national security information as it -- as it comes
 

forward in -- in an interview process. We're very
 

concerned and very much aware of our obligation to
 

protect that kind of information. And in our
 
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interview process we feel that both the person being
 

interviewed, who has held a clearance at a DOE site,
 

and understands this, and ourselves have an
 

obligation to raise that warning flag at the
 

earliest point in this process and say, I can't talk
 

over the phone about these kind of matters; we need
 

to do this in another setting. We accommodate those
 

situations as soon as they are identified. In fact,
 

we have done, I believe now, five secured
 

interviews. The interview is -- once the
 

interviewee identifies that they've got a problem of
 

this sort, we stop the interview and we reschedule
 

it in a secure location, and hold the interview with
 

a derivative classifier at the ready to make sure
 

that the notes from the interview do not breach
 

National Security, but we get the information that
 

we need to process the claim. So if there are any
 

comments or questions that come to Board members
 

about our interview process and National Security
 

information, please, you know, feel free to respond
 

that way or -- or bring them to me and we'll make
 

sure that we effectively handle and -- and deal with
 

those kinds of inquiries. 


DR. ZIEMER: Okay. Mark has a question.
 

MR. GRIFFON: Actually, probably to Larry,
 
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just to follow-up on that. I guess I would just
 

question or wonder the approach you're going to take
 

because in my own experience at some of these sites
 

is that especially the older employees tend to err
 

on the side of conservatism when it comes to
 

classified information, and they'll just assume that
 

everything that was classified in 1945, 1950,
 

remains classified today, and there may be some real
 

relevant information -- and you know this as well as
 

I do, that you could sort of squelch the interview
 

unintentionally probably, but I'm wondering -- and
 

that tends to be site-specific too, as I've learned
 

through my work, so I wonder how -- I just -- I
 

throw out that caution that I think we want to
 

encourage the interviewee to give as much about
 

their work history as they can without crossing that
 

line into National Security issues certainly, so.
 

MR. ELLIOTT: Your point is well taken, and
 

we -- we certainly recognize that some of the older,
 

former workers, you know, who have come from that
 

culture may not be aware that some of the more, you
 

know, more recent declassification of information
 

has occurred. But we -- we still don't want to see
 

them put in a situation where they feel that -- that
 

they're breaching National Security, so our approach
 
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here is to stop the interview and reschedule it in a
 

secure location where they can talk to us about
 

whatever they feel that is appropriate and necessary
 

for us to hear to process their claim. I've seen it
 

work. I think it works for these five that we've
 

done. I personally have been involved in -- in
 

trying to secure classified information from certain
 

sites, and it can be done, but we want to make sure
 

that we -- we do it right. 


DR. ZIEMER: Jim Neton has an additional
 

comment.
 

DR. NETON: Yeah, I'd just like to add a
 

little to that. We do have three more classified
 

interviews upcoming in the last couple of weeks that
 

ORAU ran across. And the approach we've taken with
 

this is if a person indicates at all that they have
 

a concern because of classification issues, we ask
 

them, because they all have a chance to review the
 

questions in advance, are your concerns at all
 

related to the lines of inquiry, the questions that
 

we are asking, and if that -- if they say yes, then
 

we -- we do not even proceed to the interview at all
 

because we feel that it may even divulge classified
 

information by knowing which questions are
 

classified kind of thing, so we'll stop it and then
 
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offer them and say we will -- we will set you up
 

with someone who is familiar with classification and
 

proceed at that time, so then they will have the
 

opportunity to proceed. We don't do partial
 

interviews, I guess that's what I'm saying.
 

DR. TOOHEY: And let me also add ORAU has
 

about a dozen employees with active Q Clearances
 

available to supplement NIOSH staff as needed.
 

MR. GRIFFON: I know that one way we dealt
 

with this and I did -- I did do some classified
 

interviews at Oak Ridge on my medical surveillance
 

work that we did down there; but also, one way that
 

Oak Ridge encouraged us to do this, Gabe Marcianta,
 

I believe the security contact down there, actually
 

did a briefing and had -- I'm not proposing that,
 

but maybe site-specific write-ups on what has been
 

declassified, so it almost -- his briefing -­

actually I was quite nervous going in having him
 

brief these people, I thought oh, boy, this is
 

really going to shut everybody up, but actually it
 

worked -- it actually worked the opposite. He said
 

to the older employees there -- the older retirees
 

there that the following things here have been
 

declassified, and feel free to divulge information
 

regarding this if -- if you feel so fit, and, you
 
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know, otherwise, if you still feel the need to go to
 

a classified interview we can make arrangements to
 

do that. But we were -- we were trying to avoid
 

having a lot of classified interviews, so maybe
 

that's a possible approach to have sort of site-


specific write-ups from -- that could be sent with
 

questionnaires. I don't know, it's just a
 

possibility.
 

DR. NETON: We had discussed that with the
 

Office of Worker Advocacy and I -- I think it's
 

still under discussion, what you're suggesting. I
 

think it's a good idea.
 

DR. ZIEMER: Thank you. Any others? Thank
 

you, Richard, for that -­

DR. TOOHEY: Thank you.
 

DR. ZIEMER: -- update on your activities. 


You may recall that at a previous meeting, I
 

think it was two meetings ago actually, we talked
 

about some possible updates on the IREP program
 

relating to latency periods for leukemia and thyroid
 

and Russ Henshaw is going to give us an update on
 

that issue now. And I think in your packet there -­

yes, there is a tab in your packet that has Russ's
 

overheads.
 

Russ.
 
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MR. HENSHAW: Thank you, Dr. Ziemer. Okay. 


Can everyone hear me okay? 


Good morning. I do want to update the Board
 

today on where we are with this whole minimum
 

latency issue regarding thyroid cancer and leukemia. 


And I'll also discuss some other IREP issues. 


And Dr. Ziemer, I certainly don't mind
 

taking questions from the Board at any time.
 

And I'll start with the latency issue, and
 

again, we're using the word latency here really as a
 

shorthand term for the time between exposure and
 

diagnosis. So I'll recap briefly what we presented
 

in October, and I'll give you an update on how we
 

intend to deal with the issue now. Recall that back
 

in October, which seems hard to believe that was
 

four months ago already, but back in October we
 

presented sort of a status report on -- on the issue
 

of latency for leukemia and thyroid cancer. We were
 

concerned that NIOSH/IREP awarded no risk, no
 

probability of causation for radiation exposures
 

that occurred within two years of diagnosis for
 

leukemia, and within three years of diagnosis for
 

thyroid cancer. We asked SENES Oak Ridge,
 

Incorporated, our contractor, to come up with a -­

an adjustment for that, a new model that did factor
 
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in some non-zero risk for those short latency
 

periods; they did so, and we presented that first
 

model to you in October. 


If you recall, our feeling at NIOSH was that
 

the science just simply did not support such a
 

severe and absolute adjustment function for these
 

two cancer models, and again, that was different
 

from all of the other cancer models at IREP; all
 

other cancers IREP awarded some probability of
 

causation at all times since exposure, these two
 

were the exceptions.
 

While we evaluated that model that SENES
 

developed, or those two models that SENES developed
 

back in the fall, one of the unanticipated -- well,
 

the unanticipated effect of the new models was that
 

they actually reduced probability of causation at
 

some time since exposure, although they did factor
 

in probability of the short latency periods. We
 

were uncomfortable with that; we didn't feel that
 

the science supported an adjustment that would in
 

effect reduce probability of causation at any time
 

since exposure. And that's pretty much where we
 

were at that time at the October Board meeting.
 

We asked SENES to pretty much go back to the
 

drawing board and look at that model again and come
 
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up with a new adjustment, and we specified two
 

conditions. And we asked them specifically to
 

develop a model where -- that would not have the
 

effect of reducing probability of causation at any
 

time since exposure when compared to the current
 

model, and also still factor in some non-zero risk
 

as appropriate at all times since exposure, even if
 

you're a zero. They did that, and developed those
 

models and presented them to both NCI and to NIOSH,
 

actually just in December, just less than two months
 

ago. 


I do have a table here of probability of
 

causation results, and I'm going to just briefly
 

explain the table if I can -- if I can do this
 

without screwing things up -- there we go. This is
 

for leukemia. This involves a set of hypothetical
 

claimant inputs: A man born in 1930, diagnosed with
 

leukemia in 1980, using the cancer model leukemia,
 

excluding Chronic Lymphocytic Leukemia, just for
 

simplicity, we used one acute exposure at 50
 

CentiSieverts; we used a constant dose, in other
 

words, no uncertainty in the dose input, and photons
 

greater than 250 keV. Then we used the default
 

sample size in IREP of 2000, and the default random
 

number seed of 99. 

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Now, just to explain the table, first of
 

all, this is the -- this is a column of results for
 

the current IREP, the one that's on our web site. 


These are the results for the model that was
 

developed back in the fall, that first alternative
 

model that we showed in October; this is the new
 

model that was developed in December. And going
 

over to the left, the left column is the age of
 

exposure; the year of exposure; and then the times
 

since exposure in years; so this person, this
 

hypothetical claimant born in 1930, exposed in 1980,
 

would be 50 years old, same year of exposure as the
 

diagnosis, so that's zero -- zero year since
 

exposure. The current model, of course, would give
 

that zero probability of causation; the model in
 

October would have awarded just for that one
 

exposure, two percent, a probability of causation
 

equal to two percent; the new model, 3.6 percent,
 

and so on.
 

You can see that, from this hypothetical set
 

of inputs all -- the two conditions are -- are
 

satisfied by the new model. Now, to fit it onto the
 

slide, I truncated this, and you see his time since
 

exposure from zero to five years, and I skipped to
 

ten, and then intervals of five, but these
 
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conditions are met also in years six through nine. 


In fact, for leukemia you can see that by year five
 

it's pretty much identical, and stays very close on
 

throughout the series. 


By the way, we're not too far off with our
 

hypothetical set of attributes. I looked at our
 

claims data base, and this, as of January 23rd, just
 

as an aside, for all leukemia claims excluding CLL
 

the mean age of our claimants is 19 -- or excuse me,
 

the mean year of birth is 1927; the average first
 

exposure, 1958; the average last exposure, 1977; the
 

average year of diagnosis, 1987. That's based on
 

334 claims as of January 23rd, 2002.
 

The new model, the new alternative model,
 

this far-right column uses a midpoint or the 


S-shaped function, if you recall that -- that lingo
 

from October, the S- -- the S-shaped function is the
 

actual adjustment that reduces probability of
 

causation for short latency. The midpoint of the
 

new model is 2.25 years. That's a change from three
 

years for the -- that first model that we showed in
 

October. And to account for the uncertainty, it
 

actually -- it adjusted the midpoint from 2 to 2.5
 

years; the midpoint is 2.25, it adjusts from 2 to
 

2.5. 

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Any questions on the table before I move on?
 

DR. ZIEMER: What -- remind us again, what
 

does the curve look like at the low end? In the
 

previous one they had proposed a linear function
 

between zero and two years, was it, or not? 


MR. HENSHAW: Well, recall that -­

DR. ZIEMER: Well, originally, you had a
 

stepping function, but then the -- the one you
 

talked about in October between zero and two years,
 

was it linear?
 

MR. HENSHAW: Well, remember that IREP only
 

uses whole years -­

DR. ZIEMER: Right. 


MR. HENSHAW: -- for adjustments.
 

DR. ZIEMER: Okay. 


MR. HENSHAW: So the -­

DR. ZIEMER: So they were just point values?
 

MR. HENSHAW: Yeah, the graph I had in
 

October I think may have been a little confusing
 

because I had -- I had it drawn that way.
 

DR. ZIEMER: Yeah, the dots. Yeah. 


MR. HENSHAW: Yeah.
 

Okay. To move on to the new adjustment for
 

thyroid cancer, it's the same set of hypothetical
 

inputs. With -- with thyroid cancer you can see
 
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that the probability of causation for the three
 

models converge on this table of ten years. Again,
 

it's truncated, so I don't have years six through
 

nine on here, but it actually converges at about
 

eight years. From that point on, the thyroid cancer
 

that results are virtually identical. And you can
 

see that the conditions we specified are satisfied
 

here as well. For the model on the web, no
 

probability of causation years one through three,
 

that was the October model; the new model addresses
 

those other concerns and still factors in -- still
 

factors in the appropriate probability at each
 

interval. One thing I noticed, this is just by
 

chance with this hypothetical set of claimants, but
 

the new model actually would make the difference
 

between compensation and no compensation at a time
 

since exposure of five years, as you can see there,
 

47.3 versus 56.3. Of course, you know, most of the
 

claims, there are a series of exposures and this -­

this single exposure would be just one of the dose
 

inputs into IREP. By the way, I looked at also our
 

average claimant for thyroid cancer, and again we're
 

not too far off on this hypothetical set of inputs. 


The attributes of our average -- the average DOE
 

worker with a thyroid claim in our data base was
 
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born in 1934; was first exposed to radiation in
 

1964; the last exposure, 1983; and the average year
 

of diagnosis was 1989. The thyroid S-shaped curve,
 

the -- the new model, again the model on the right,
 

has a midpoint of 5 years with a variance around the
 

midpoint ranging from, I believe it's 4.5 to 5.5. 


I'll double check that. The old model had the same
 

-- not the old model, but the first alternative
 

model presented in October had a midpoint of 5, but
 

varied from 3 to 7 at the midpoint, so this tightens
 

that up to address the problem of not reducing
 

probability of causation at any time since exposure. 


Any questions on -- this is pretty dry stuff, but
 

any questions on any of this before I move on to
 

other IREP issues?
 

DR. ZIEMER: Russ, one other question and
 

maybe comment. This -- this is done specifically
 

for claim issues. How -- is NCI planning to utilize
 

this model in any way?
 

MR. HENSHAW: Well, that's -- that's an
 

interesting question. Actually, back in October our
 

understanding was that NCI's intention was to adopt
 

the -- the model shown in this (indicating) column. 


Since that time we've had some discussions with NCI,
 

and also with SENES. As you may know, SENES is also
 
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the contractor for NCI, as well as NIOSH, so we've
 

king of got a three-way working relationship on
 

this. And as of about two weeks ago, or my
 

understanding is that NCI has shifted on that, and
 

now intends to adopt -- or is leaning towards
 

adopting this latest model that was presented in
 

December. I think they have some internal
 

discussions and, you know, issues to resolve there,
 

but that's -- that's what our understanding is as of
 

a week or two ago. So we'll be in harmony there. 


DR. ZIEMER: Well, presumably the -- the
 

science itself doesn't support one versus the other
 

intrinsically. Is that a fair statement? So that
 

the real reason for doing this would be to -- for
 

us, would be to provide some degree of consistency
 

with how we handle claimants in terms of the nonzero values of the other coefficients of the other
 

cancers. 


MR. HENSHAW: Yes, I believe that is a fair
 

statement. 


DR. ZIEMER: Scientifically, you can make
 

the case for either I guess. Is that true?
 

MR. HENSHAW: Yes, that's correct. 


Latency -­

DR. ZIEMER: Or you could equally not make
 
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the case for either, which -- however you want to
 

look at it.
 

MR. HENSHAW: The latency is perhaps the
 

hardest aspect of the modeling to actually -­

actually do, and the science is rather ambiguous on
 

it, especially with respect to leukemia; it'd be
 

less so for thyroid. But we felt that this -- this
 

was one of -- this was an issue that pretty clearly
 

cried out for -- for adjustment. That's, you know,
 

based on our -- our mission of using science where
 

there is science, and being claimant friendly where
 

the science fails.
 

DR. MELIUS: What is the status of NCI
 

finishing up IREP and getting reports out. I think
 

you were expecting that several months ago.
 

MR. HENSHAW: Well, I mean I wish I knew,
 

but I've heard, this is just by word of mouth, that
 

they have another draft of their working report. I
 

believe it was sent around for internal peer review
 

in NCI early in December. I don't know where it is
 

at this point or when they intend to release it
 

beyond their internal review. I have not seen it
 

myself.
 

DR. MELIUS: Go ahead.
 

MR. ELLIOTT: I think that some of the
 
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changes that we have sponsored has triggered some
 

revision in their working document, and they, of
 

course, are going to have to get that explained and
 

then cleared through the department. I know that
 

the -- I think Mike Schaeffer is here from DTRA, but
 

he may feel -- he may want to speak to this, but
 

there's also between the Department of Health and
 

Human Services where NIH and NCI is located, their 


-- this is their product to deliver to the VA for
 

the VA's use. And until the VA's Advisory Board is
 

reconstituted to review and advise the VA on the
 

NCI/IREP, it will stay in -- in somewhat a limbo of
 

draft until that is done, so -- and I don't know
 

where they're at with regard to their establishment
 

and reincarnation of their Advisory Board. 


DR. MELIUS: What about, and this may be my
 

memory also, but the NAS review of the report, was
 

that underway also?
 

MR. ELLIOTT: The NAS review was finished,
 

and they reacted and addressed all of the National
 

Academy of Sciences comments. That was handled in
 

the -- in a early version that you all saw, and I
 

think -- I believe that part of their process is
 

concluded. I'm not absolutely certain, but I think
 

it has.
 
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DR. MELIUS: I'm not sure exactly where we
 

stand because we adopted IREP -- NIOSH has adopted
 

IREP into its regulations, correct? Am I correct in
 

terms of -- what did you adopt? 


MR. ELLIOTT: We have a NIOSH/IREP. And it
 

is what it is as it stands. It's based upon the NCI
 

work and version, and we collaborated with them. We
 

certainly, again, have made and sponsored some
 

changes that they have thought through and adopted
 

as well, but the -- you know, the NIOSH/IREP is
 

approved, it is a department commitment and it's
 

there for use, and it, you know, it was reviewed by
 

you all. It stands to be revised with substantial
 

modifications, and there's a process that -- that
 

will support that. The Advisory Board needs to
 

address substantial modifications in a review and a
 

public comment period and provide recommendation to
 

the Secretary on such modifications. We don't think
 

this is a substantial modification, we think this is
 

just a fix, and we would like to proceed with this
 

fix. We've presented it to you twice, once in
 

October and now again, with what we think is a
 

logical and appropriate claim-favorable attempt to
 

correct these two cancer risk models in IREP. We
 

have at least, I know of one leukemia claim that's
 
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pending resolution of this fix.
 

DR. ZIEMER: You may recall that we had the
 

discussion in October as to what the Board's role
 

was even on this matter, it was the issue of does
 

this rise to the level of -- of being substantive or
 

not. In either case, it certainly would not be
 

inappropriate for the Board to indicate its reaction
 

if it wishes to -- if I might use the word "bless
 

this fix" or "curse this fix." We certainly have
 

that opportunity. And I think certainly the staff
 

will be quite open to hearing feedback from the
 

Board as to how you react to this particular
 

proposed adjustment to the model.
 

And Wanda, do you have a comment?
 

MS. MUNN: I guess my sense is that given
 

our -- our prior commitment to being claimant
 

friendly, that one probably can support the new
 

suggestions that are being made. I think we need to
 

make very clear what the discussion just was: That
 

the science really does not support what we are
 

saying here. I have concerns that once these types
 

of assumptions are made, are quantified, and put in
 

a table somewhere, that they end up showing up in
 

courts of law with attorneys arguing that this body
 

has found this to be true, when in point of fact, I
 
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don't think what we're saying is this is true. I
 

think what we're saying is this is our attempt to
 

try to be as conservative on behalf of the claimants
 

as we possibly can. Now, I don't know quite how we
 

can differentiate that and -- and make that clear,
 

but it does bother me if we can't point directly to
 

the science and say this is what we've got.
 

DR. ZIEMER: That's certainly an appropriate
 

comment. I think we also can make the comment that
 

the science did not support the old model either, so
 

either one is equally weak in that area, so it comes
 

down to what is a reasonable approach. This seems
 

to be reasonable in light of how we're handling the
 

other risk coefficients and the other -- I'm
 

searching for the right word -- it's the latency
 

period, I guess is what we're talking about.
 

Okay, Jim.
 

DR. MELIUS: Yeah, just to follow up. I
 

agree with what you just said, Dr. Ziemer, but also,
 

this is not in response to Wanda's comment. For
 

better or worse, IREP with sort of the mathematical
 

modeling and the dealing with uncertainty serve -­

in a lot of areas there's compromise and it ends up
 

in between what may be, you know, weighing things,
 

so I'm not sure we're really endorsing one science
 
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versus another, it's a way of saying -- it's a way
 

of capturing the uncertainty that is there, or the
 

lack of data, or lack of certainty about that, and
 

to me it's an appropriate adjustment for that. I'm
 

not saying one way or the other on how this would,
 

you know, it's not a yes or a no on some things,
 

it's a way of compromising in the middle, not the
 

way we're used to doing it either, which makes it a
 

little bit more difficult.
 

DR. ZIEMER: Gen.
 

DR. ROESSLER: Well, I agree it's claimant
 

friendly, but I think there is some science to
 

looking at this new approach because things don't
 

just end or begin at two years. There's biological
 

variation, and I think there's a scientific reason
 

for doing it this way, so I don't think it's, you
 

know, I think it's a very reasonable approach, plus
 

it matches with the other cancer models. And I
 

think the whole thing's consistent and I frankly
 

think the Board has every reason to say they should
 

go with it.
 

MS. MUNN: Yeah.
 

DR. ANDRADE: I would just like to add my
 

support to the statements and to the concerns that
 

Wanda expressed. I believe that indeed there is
 
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biological variation, and we're going to see cases
 

that span a distribution of latency periods;
 

however, I don't believe the science, even up to
 

BEIR VII, is such that one can make any sort of
 

definitive statement that the science is there, or
 

that the uncertainty is small enough that we feel
 

very confident in this. And I really support the
 

idea of somehow putting into the record, perhaps
 

even into any new legislation that arrives or that
 

is sponsored, or that we help support, the fact that
 

we are dealing with basically a compassionate
 

approach and that at this point in time decisions
 

made in favor, if this Board does choose to support
 

this model, are being done so with that philosophy
 

in mind, and that is all.
 

DR. ZIEMER: Larry.
 

MR. ELLIOTT: Thank you. I appreciate
 

hearing these thoughts, and I think there's one way
 

we can get at what you're asking for, Dr. Andrade,
 

and that is to add something to a paragraph or two,
 

or a section to the technical documentation for
 

IREP. You recall we have technical documentation,
 

it's on our web site. You've all been given a copy
 

of it. I think we perhaps need to go into that and
 

account for these kind of changes or these kind of
 
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fixes and show where we're compassionate. We need
 

to speak about, you know, where we become claimant
 

favorable and friendly because science doesn't
 

afford any further opportunity of its use, so maybe
 

that's where we can locate this, in the technical
 

documentation.
 

DR. ZIEMER: Okay. Russ, I think you can
 

proceed. You have a couple additional slides.
 

MR. HENSHAW: On this issue I just want to
 

add that we -- we considered this from the beginning
 

a -- this particular change to fall under the
 

category of administrative policy, and not -­

there's no pretention that we're prepping new
 

science here, so. 


But anyway, moving on to a few other issues,
 

we'll focus on three topics for the remainder of
 

this presentation. The first, the recent revision
 

of our NIOSH/IREP User's Guide; second, brief
 

changes -- a summary of changes made to the software
 

since April of 2002, and the reason it's April 2002
 

is that's when the first NIOSH/IREP User's Guide was
 

distributed to the Department of Labor claims
 

examiners and staff; and finally, discussion of
 

scientific research issues. And I had the pleasure
 

of reading, by the way, the IREP Workgroup's slides
 
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last night, and I think we're pretty much on the
 

same page there. There are a few differences, but I
 

think we're all moving in the same direction anyway.
 

But going on first to the NIOSH/IREP User's
 

Guide -- incidentally, we Fed-Exed a copy of this to
 

each Board member last Thursday. Did anyone not
 

receive the User's Guide?
 

MR. PRESLEY: I haven't gotten one.
 

MR. HENSHAW: You didn't get it?
 

MR. PRESLEY: (Shakes head negatively.)
 

MR. HENSHAW: If you -- when you get home,
 

if it's not there, would you, you know, let us know
 

and we'll get you another copy. Get another copy to
 

you. 


I don't know if you've had a chance to look
 

this over or not, but I should mention it's designed
 

really specifically for the Department of Labor for
 

use by their claims examiners in adjudicating
 

claims, although I think it probably could be
 

helpful to other users as well. But the major
 

changes are expanded glossary, we talk about the
 

file-naming convention, and that's simply the 


file-naming I'm referring to the Excel template
 

files that NIOSH sends to DOL, which abstract the
 

dose reconstruction and provide the inputs for IREP. 

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We go into a much greater detail on how -- how to
 

deal with multiple cancer claims, and claims
 

requiring more than what IREP run. The User's Guide
 

has some new screenshots which hopefully -­

hopefully make it more user friendly. 


And I might add, I'm not sure -- we talked
 

about this briefly, but Larry, are we going to post
 

this at some point on our web site, the User's
 

Guide, or provide it with some other means of making
 

it available?
 

MR. ELLIOTT: I must have been asleep at
 

that point in time. Certainly we can. We can put
 

this up there. Of course, there's, you know, the
 

diskette that we provide, that would perhaps not be
 

amenable to put on the web site, I don't know, but,
 

yeah, we can put it on the web site.
 

MR. HENSHAW: Okay, moving on. Really, just
 

about all the -- all of the changes made to the
 

software since April have fallen into the category
 

of User Interface Changes. We have a new opening
 

screen that allows the user to, you know, choose one
 

of two buttons, one goes -- one leads to a set of
 

manual inputs, the other leads to use of the Excel
 

template file. We now have a -- a random seed
 

number generator function, that's in the advanced
 
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feature section. Formerly, we were expecting people
 

to use a random number table or some other generator
 

to do that, and that seemed unrealistic, so we have
 

that incorporated into the software now. And
 

incidentally, the way IREP works, on this random
 

number seed is the same random number seed for the
 

same set of inputs will always produce the same
 

probability of causation result. IREP uses an
 

algorithm that, you know, accomplishes that. I
 

think it's called a mark-all-chain, statistical
 

terminology. 


By the way, this is an aside, this just
 

occurred to me recently. The word "algorithm" is in
 

one sense an oxymoron. I don't know if you've
 

thought about this, but think about it: Algorithm,
 

Al Gore Rithm.
 

We also have the -- we have an online
 

multiple primary cancers calculation button now, and
 

fields to enter results from the different, separate
 

primary runs. Before that, the Department of Labor
 

claims examiners had to plug results into a
 

mathematical equation. And a work in progress, it
 

should be set up hopefully within the next couple of
 

weeks, is to provide online links to the NIOSH/IREP
 

technical documentation from the software.
 
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81 

Okay. On to a more important topic, I
 

believe, the issue of scientific research and what's
 

needed. Of course, you know IREP is derived from a
 

set of radio -- excuse me, a set of tables and
 

cancer risk models and methodologies first
 

introduced in 1985. And our version of IREP was
 

created under the time restraints -- under the time
 

constraints imposed by EEOICPA and was never
 

intended to be a stationary product. It was
 

recognized from the beginning that more research is
 

needed, and that changes should be made as
 

appropriate as time moves on. I believe we're at
 

that phase of the program now, and I think the
 

beginning of that was the proposed changes for the
 

leukemia and thyroid latency, but there are a lot
 

more issues that we need to deal with and more
 

issues of more substance. 


I have a list of research needs that should
 

not be construed as complete, nor are they in any
 

priority order. These are topics that I just
 

compiled from -- from discussions, and e-mail
 

exchanges, and from Mary Schubauer-Berigan's
 

original work over the past year. I just tried to
 

give a thumbnail sketch of some of what we feel is
 

important to -- to focus on. As I mentioned
 
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earlier, I think many of these, if not most of them,
 

are also on your list and I think you have one or
 

two items that I did not include here. I did not
 

use your list, the Board, the IREP -- using the IREP
 

workgroup's list in constructing this one, but I'm 


-- I'm pleased that they're very similar. So this
 

is really just a partial list, I guess. I think
 

everyone agrees that DOE Occupational Studies need
 

to have more of a presence in IREP risk modeling. 


That's -- that's number one on the list. I think we
 

also need to look again at the -- our transfer model
 

as the risk coefficients of transferring the
 

Japanese cohort experience to our workforce. Age at
 

exposure is a very important issue, and that's -­

that's a multi-faceted issue. We also, at some
 

point, whenever it's appropriate, then we need to, I
 

think, update cancer incidence rates. Smoking and
 

lung cancer is an often-raised issue, and again,
 

that's multi-faceted. Some of the things that we
 

need to consider regarding the smoking adjustment
 

are -- are smoking categories, the definitions of
 

our categories, and what constitutes a nonsmoker,
 

and at what point -- how many years must pass after
 

a person quits smoking before he or she can be
 

considered a nonsmoker, or close to a nonsmoker. 

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Right now we have a former smoker category. There's
 

a lot of work to be done with smoking and lung
 

cancer, I think. Also, the race/ethnicity issue,
 

the adjustment for skin cancer. And perhaps the
 

large -- one of the largest, if not the largest
 

sources of uncertainty in our risk modeling, the
 

DDREF adjustment. And I mention, I think on your
 

list you have CLL and other leukemias, probably so,
 

I just -- I list only Chronic Lymphocytic Leukemia
 

here because, as you know, it's the only cancer
 

that's excluded from compensation, and I think we
 

should reevaluate that.
 

The last item on this list has to do with
 

interactions with workplace exposures, chemicals. I
 

think that, frankly, will be very difficult to
 

adjust for. I don't -- I'm not sure how realistic
 

it is to do anything with that in the near future,
 

but I think we're all certainly receptive to
 

considering it anyway. 


I might add also, NCI just within the past
 

month has begun looking at the latency reduction
 

function for bone cancer. Their thinking is that -­

well, let me back up. Right now the IREP -­

NCI/IREP and NIOSH/IREP use a latency reduction
 

function for bone cancer that's similar to other
 
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solid tumors which provides a midpoint, and I think
 

it's 7.5 -- it's 7 or 7.5 years. Their thinking is
 

that bone cancer more closely models thyroid cancer,
 

and I -- I expect to hear that -- some announcement
 

at some point that they -- that they will be
 

changing that, so -- so we need to put that on the
 

list as well.
 

I'd certainly be happy to hear any questions
 

or comments on this, but I just want to say that we
 

really look forward to working with the Board and
 

with the IREP workgroup to come up with a design for
 

research that really addresses the needs of the
 

workforce covered by EEOICPA, so I think we have a
 

lot of work to do. 


DR. ZIEMER: A comment or question from 


Dr. Roessler.
 

DR. ROESSLER: I think, unless I fell
 

asleep, you skipped over the BEIR VII line in your
 

slide, and I'm wondering, it seems that BEIR VII
 

should, or will cover a number of things that you
 

have on this slide, and I'm wondering what is the
 

status, is it out officially, or have you at least
 

had a preliminary copy so you can anticipate what
 

your work might be?
 

MR. HENSHAW: The answer to those questions
 
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85 

are, I think, no, no, and no. I -- I do not have a
 

copy of it. I don't know -- I haven't heard any
 

status report on it, and I don't know, maybe Larry
 

knows something that I don't.
 

MR. ELLIOTT: I think the BEIR VII Committee
 

is still under its deliberations. They're still
 

working through. I've been trying to find out
 

whether or not they have meetings scheduled for -­

for this upcoming year. I'm sure they do, but I've
 

been unable to determine that at this point.
 

MR. HENSHAW: To your question about whether
 

BEIR VII will address many of these issues or
 

resolve many of these issues, yeah, I think that
 

will address most of these issues, and certainly it
 

could be a starting point for our reevaluations.
 

DR. ZIEMER: My understanding is that BEIR
 

VII is basically complete except for the fact that
 

the Japanese dosimetry is being redone, and those
 

risk coefficients may change slightly, so basically
 

as soon as RERF comes out with -- or actually it's a
 

separate task group, it's a dosimetry task group,
 

comes out with their new information, which is
 

supposed to be this spring, then it's plugged and
 

chugged into a couple of tables in BEIR VII and
 

they're ready to go, is my understanding. But then
 
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86 

you realize that in the National Academy's process,
 

then there's this whole layer of review, and I know
 

on BEIR VI there was over a year between the
 

completion of the report and the getting it on the
 

street, so whatever represents a fast track for the
 

Academy is going to be something like that. 


MR. HENSHAW: I gather also that there is
 

some controversy about how it's going to shake out
 

in terms of providing support for more claimant-


friendly approaches, or less claimant-friendly
 

approaches in IREP, so we'll just have to wait and
 

see. 


I might, one thing I just thought of is the
 

comment on the smoking adjustment in IREP. One of
 

the things I hear and I think it's a misconception. 


One of the things I hear from time to time is we
 

should just throw out the smoking adjustment. We
 

can't really do that, even if we wanted to, it would
 

not be fair to anyone because the risk model is
 

based on the Japanese cohort who were considered to
 

have been moderate smokers, thus the adjustment goes
 

-- the smoking adjustment goes both ways at IREP. 


If we were to simply remove it, that would not be
 

fair to nonsmokers because they're in effect
 

penalized by the heavier smoking experience of the
 
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Japanese cohort, so it's a very complicated issue,
 

it does not lend itself to an easy fix.
 

DR. ZIEMER: Any other questions for Russ?
 

Thank you very much, Russ. 


We're going to take a break in a moment. I
 

do want to point out to the Board that if you do
 

wish to take any formal action relative to the fixes
 

that -- that NIOSH is intending, it certainly is not
 

inappropriate to do so; that is, you can endorse
 

them or as I said, you can bless them, curse them,
 

or ignore them. And I -- I would say from where I
 

sit it would not be inappropriate if you -- if you
 

would like to go on record to actually propose a
 

motion that would say in effect the Board is in
 

agreement with the proposed fixes and endorses them. 


Tony.
 

DR. ANDRADE: I certainly would like to be
 

able to propose a motion; however, you know,
 

previous -- in previous discussion with Larry, he
 

mentioned that we might be able to address the quick
 

fixes insofar as our consensus as to how we feel
 

about these and -- and the fact that perhaps in some
 

cases we are being claimant friendly, or in some
 

cases we are adopting them because new science
 

points out that we should. And Larry mentioned that
 
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88 

we could include this type of information in
 

technical documentation, so I wanted to ask for
 

perhaps a little bit more clarification. 


Larry, were you talking about technical
 

documentation such as the IREP, what do you call it,
 

Guide, or some other form of documentation?
 

MR. ELLIOTT: I was referring to the
 

technical documentation that supports the cancer
 

risk models in IREP, not this User's Guide that Russ
 

sent out to you by Fed-Ex last week, or you've seen
 

in the past. I think that we can simply put a new
 

section into that technical documentation titled
 

Administrative Policies, perhaps. And there we can
 

account for where science doesn't serve us well
 

anymore and we need to take a claimant-favorable
 

approach, and we can outline how that approach is
 

claimant favorable.
 

DR. ANDRADE: So what you're proposing is a 

new -­

MR. ELLIOTT: New section or -- or something 

to the -- it's been a while since I've looked at the
 

technical documentation. I recall it being, you
 

know, it has different sections in it; it talks
 

about different cancer risk models; it talks about
 

the transfer issue from Japanese survivor experience
 
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89 

to the American workforce. I think we can add a new
 

section to that that talks about administrative
 

policies.
 

DR. NETON: Larry, if I could just add to
 

that that this is very consistent with the current
 

IREP documentation that exists where every cancer
 

model that we've adopted has a fairly detailed
 

discussion as to the science behind it and where we
 

were claimant favorable. We were very careful to
 

point that out because the science could not support
 

any other model. So I really think that this would
 

just be a modification to the leukemia discussion of
 

the risk models in the IREP documentation now, and
 

we would just be consistent with our past approach.
 

All of our models have these type of
 

discussions about whether they're based on pure
 

science or the lack of science, you know, but will
 

be claimant favorable. I think that's the
 

appropriate place to do that.
 

DR. ZIEMER: I also don't want to
 

necessarily have a precedent that every minor change
 

in IREP requires Board action. I'm simply reminding
 

you that there was some uncertainty last time as to
 

whether this particular item reached the level that
 

would require Board action, and one thing that could
 
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90 

be done that's somewhat in between would be simply
 

to go on record indicating that, for example,
 

there's no objections, or that the Board is in
 

agreement with this change, or has no problem with
 

it, something like that.
 

Roy.
 

MR. DeHART: Yes. I think the -- I would
 

like to see the Board agree that the changes that
 

are recommended for the leukemia/thyroid model is
 

consistent. 


DR. ZIEMER: Are you making some sort of a
 

motion, or is this -­

MR. DeHART: I can make a motion -­

DR. ZIEMER: -- just an observation?
 

MR. DeHART: -- of that if you wish. It was
 

an observation primarily that they are making these
 

changes to be consistent to the other models that
 

they had. 


DR. ZIEMER: Anyone else wish to comment,
 

or?
 

DR. MELIUS: Only the fact that I -- I think
 

we probably should make it a simple motion. I don't
 

disagree with what Roy just proposed, but I'm afraid
 

we can get -- we can spend a long time trying to
 

figure out the exact wording to justify this and to
 
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91 

reflect the diversity on the Board, and I would
 

think it's maybe just better if we just try to
 

something straightforward.
 

DR. ZIEMER: Well, for example, a motion
 

that said the Board is in agreement with the
 

proposed fixes in the latency adjustment for
 

leukemia and thyroid, and has no objections to their
 

being implemented. 


MR. DeHART: (Raises hand.)
 

DR. ZIEMER: Did somebody move that?
 

MR. DeHART: I moved it.
 

DR. ZIEMER: That was what Roy was intending
 

to say. Actually, it's a very unsanitary way of
 

speaking, it's putting words into other's people's
 

mouths, but -­

WRITER/EDITOR: The motion was made by Roy?
 

DR. DeHART: Yes, Dr. DeHart.
 

WRITER/EDITOR: Thank you.
 

DR. MELIUS: I'll second the motion.
 

DR. ZIEMER: And this is intended that this
 

be a motion of general agreement, not -- Wanda, you
 

have a comment?
 

MS. MUNN: I really would like to add to
 

that the kind of caveat that Larry just indicated,
 

that the rationale -­
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92 

DR. ZIEMER: And the Board -- and the Board,
 

for the record, recommends that the -­

MS. MUNN: That the -­

DR. ZIEMER: -- staff clearly specify the
 

reasons for these adjustments -­

MS. MUNN: Right.
 

DR. ZIEMER: -- in the documentation. That
 

was part of your original motion, was it not?
 

MR. DeHART: That was the amendment to my
 

motion.
 

MS. MUNN: Thank you for that unsanitary
 

amendment.
 

DR. ZIEMER: An extremely -- an extremely
 

friendly amendment.
 

DR. ANDRADE: I second that one.
 

DR. ZIEMER: Well, that was not a motion, it
 

was a friendly amendment we had already agreed to. 


Now, I -- I don't want to presume that this is -­

are there comments on -- I'm trying to develop the
 

sense of the Board here very quickly because
 

everybody is wanting a break, which is the best time
 

to have motions, actually.
 

DR. ANDRADE: Exactly. Paul, I think it's
 

extremely important and I'll reiterate that down the
 

-- down the years, in the years that follow that
 
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93 

people -- it is important for people to understand
 

that we're not endorsing the science that currently
 

exists, and that it not be used as a basis for say,
 

legislative -- legal action, and that sort of thing. 


I think it's extremely important that we at least
 

put in the phrase that we are endorsing this as a
 

result of, or following the compassionate
 

philosophy.
 

DR. ZIEMER: So the motion would really
 

read: The Board is in agreement with the proposed
 

fixes in the latency adjustments for leukemia and
 

cancer and endorses the changes presented as a means
 

of incorporating a compassionate -­

MR. GRIFFON: I just -- I'm reflecting back
 

on what Dr. Melius said about we can end up with a
 

complicated motion here instead of a very simple,
 

because I think I'd add -­

DR. ZIEMER: It's going to be less and less
 

simple.
 

MR. GRIFFON: -- I think what we've heard
 

around the committee here is that it's not only the
 

compassionate, it's also the uncertainty of the
 

science, so I think that there's kind of two sides
 

going on there. And I think we're just -- I was in
 

agreement with the first motion with all this other
 
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94 

stuff understood, you know.
 

DR. ZIEMER: Okay. We'll go with the motion
 

as it was originally -- is that -- everybody
 

understands that?
 

MR. ESPINOSA: Can you repeat it?
 

DR. ZIEMER: The motion is the Board is in
 

agreement with the proposed fixes in the latency
 

adjustments for leukemia and thyroid, and endorses
 

the -- or, let's see -- and endorses the changes as
 

presented. The Board further recommends that the
 

documentation specify the reasons for the changes.
 

MR. ESPINOSA: I'm all right with that.
 

DR. ZIEMER: Okay. Are you ready to vote on
 

this? All in favor of the motion, say Aye.
 

BOARD MEMBERS: Aye.
 

DR. ZIEMER: Any opposed, say no.
 

(No response.)
 

DR. ZIEMER: Any abstaining?
 

(No response.)
 

DR. ZIEMER: The motion carries. Thank you
 

very much. We are going to have a 15-minute recess.
 

(Whereupon, a recess was taken.)
 

BY DR. ZIEMER: (Resuming)
 

You may recall that Jim Melius was the
 

Chairperson for our Working Group on IREP issues,
 
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95 

and he's going to present the report. We actually
 

distributed a draft of this report at our last
 

meeting I believe, at the end of the meeting.
 

DR. MELIUS: And the draft hasn't changed.
 

DR. ZIEMER: And the draft hasn't changed. 


Give us an update and some additional comments, Jim.
 

DR. MELIUS: The workgroup -- which was
 

myself, Henry Anderson, and Leon -- I'm the only
 

person that made it here today, so I can now report
 

that all of our conclusions were unanimous and no
 

one will disagree -- seriously -- was charged with
 

looking at the issue of how do we set up a review
 

process for looking at dealing with IREP and other
 

scientific issues that have come up or may come up
 

in dealing with the -- this overall claims
 

processing, and dose reconstruction in particular. 


And also to come up with a process for -- some
 

recommendations in terms of what might be some
 

priority topics, and then also related to that was 


-- was also the issue of consistency with some of
 

the other radiation compensation programs. 


So in doing that we sort of, you know,
 

consider what would be some of the reasons for
 

wanting to bring things up for review. And clearly,
 

it would be that there's some limitation or some
 
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96 

problem with -- of the science that was being used
 

for IREP models or some of the other models used in
 

dose reconstruction. In looking at this, most of
 

the time these limitations are usually related to,
 

not to the model itself, it's not a problem with the
 

scientific model we used, but -- but often with its
 

applicability to this particular group of workers,
 

or to this particular situation. And certainly, you
 

know, and we know that, for example, IREP is based
 

for the most part on atomic bomb survivor data, and
 

so how applicable is that. Some of the dose
 

reconstruction ICRP models are -- are based more on
 

-- on dealing with worker protection issues, and so
 

it may not have considered, or some of the
 

assumptions used may not -- may not always be
 

appropriate for certain cases that might come up in
 

-- in this program. So it's not always a question
 

necessarily of the basic model involved or models,
 

but rather, either the limitations of the
 

applicability of those or limitations due to some of
 

the assumptions, the situation being different for
 

here. 


We also may want to review the science to
 

try to improve -- make some improvements to IREP or
 

the other model used for this application, so this
 
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97 

is the obvious issue of applicability or
 

assumptions, but rather that, look, there are issues
 

there; and again, an example being would come up
 

that we know there's limitations to that science,
 

what can -- there are now some new data out or new
 

information out that would allow us to -- to make
 

changes in this and that.
 

We also want to provide, I think, some level
 

of consistency, or at least be able to address
 

inconsistencies that might occur between the IREP
 

application and other model applications used for
 

this program compared to some of the other
 

compensation programs. And I think the smoking
 

example that came up earlier would be one example
 

that some of the other ongoing changes going on at
 

IREP that, as it's being developed for the VA
 

program may also raise some questions of
 

inconsistency, and while there's no requirement that
 

the programs be -- all be consistent, I think there
 

could be times when those inconsistencies should at
 

least be explained or addressed in some way. Now,
 

some of the inconsistencies may come out of the
 

legislation, so we can't -- can't directly address
 

that here, but. 


Finally, there may be -- we may want to
 
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98 

bring up scientific issues because there's some sort
 

of a perceived problem. The claimants feel that the
 

model is being applied to them and their dose
 

reconstruction is not fair to them, is the
 

perception. And that -- and us, as a committee, and
 

NIOSH in trying to respond to those concerns, would
 

we want to review a certain part of the model. That
 

review may very well affirm what's being done, but
 

it would at least allow some public discussion, and
 

review of -- of what is perceived to be some
 

unfairness in either -- let's say in the model
 

itself, the basis that's used for dose
 

reconstruction that's underway.
 

I came up with a -- we came up with a list
 

of topics that were based on -- I went -- actually,
 

I went back through some of the earlier comments
 

that came in on IREP and the dose reconstruction
 

procedures, went back through some of the peer
 

review comments that had been submitted. There were
 

some issues that came up, either from the Board or
 

from the public comments as the Board was in the
 

process of reviewing IREP and reviewing the dose
 

reconstruction procedures, and a few that I believe
 

had come up in later Board -- Board meetings. So
 

it's not necessarily meant to be an exhaustive list,
 
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99 

but I think it -- I think it does at least capture
 

the ones we had already talked about, or had already
 

-- at least there was some issue about. In fact, I
 

think on some of these we, when at the time we
 

adopted the NIOSH -- NIOSH/IREP, we specifically
 

pointed out that these topics need to be discussed
 

in more detail at a later point in time, or reviewed
 

in more detail at a later point in time, so -- and
 

many of them I think were issues that NCI, NIOSH,
 

everybody sort of grappled with already, and now are
 

pretty well known and so forth, and -- but, you
 

know, as part of this program we had talked about,
 

or it had been brought up as something that might be
 

-- might be discussed. This is not a prioritized
 

list, it's not a comprehensive list, and it may
 

change over time; to some extent it's changed
 

already. Someplace on the list is leukemia, the
 

latency for leukemia and thyroid, and so I think
 

we've gone beyond that now, that list. And, as I
 

said, these are some of the same issues that Russ
 

brought up, so it's the smoking adjustment came up
 

for lung, and also could come up for other cancers;
 

this whole issue of age at exposure and survivor -­

survivor population, incorporation of occupational
 

studies. It's not the issue of interaction
 
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100 

necessarily with the chemical or other toxic
 

exposures in the workplace, but rather the -- the -­

the issue of how do we, or should we take into
 

account, or IREP take into account some of the
 

occupational health cohort, those issues of
 

comparison population and -- and so forth with that,
 

and -- and there's actually some, I believe, in the
 

legislation itself that actually doesn't require
 

that, but certainly promotes the idea that that -­

the fact that these are of occupational cohort ought
 

to be taken into account. The issue of CLL and
 

other leukemias, and this is an issue both of -- I
 

think it came from legislation, CLL, but as much as
 

the fact that our classification of leukemias is
 

changing, and our understanding of leukemias is
 

changing, and how do we properly take that into
 

account in -- in this compensation process. 


Again, this issue with the occupational
 

cohorts as well as the difference between the
 

Japanese population and -- and here in terms of
 

incorporation of background cancer risks, there's
 

some issues that came up in terms of how should some
 

of the less common types of cancers be grouped in
 

this process, and is that grouping -- current
 

grouping appropriate, need to be changed. The whole
 
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issue of dose rate over the DDREF adjustment, which
 

we actually discussed at an earlier meeting was a
 

subject of some of the peer review that NIOSH had,
 

it took place for earlier in the development of the
 

regulations and so forth with that. 


And those are, I think -- I think is a
 

fairly comprehensive list of the issues that we had
 

discussed or had been brought up -- brought up to
 

the Board at the time. 


Now, what we talked about in terms of a -­

of a process for doing this, a recommended process
 

for doing this is, one, we need to prioritize the
 

topics; what does it make sense to do, what's an
 

appropriate schedule for -- for dealing with -- with
 

some of these, and then some of them we may very
 

well say are things that are a few years down the
 

road, or if ever could be dealt with. Then, much as
 

they did for the thyroid and leukemia, I think the
 

NIOSH staff or contractor staff, however they want
 

to do it, would prepare a background briefing that
 

would include -- could include recommended changes,
 

could just review the science and so forth, but that
 

-- or policy options that might be considered -­

that report would go out for some sort of outside
 

peer review or consultation, and that consultation
 
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may be with agencies like NCI and so forth, the peer
 

review may be various outside scientists, so there
 

would be a record of -- of that process and so
 

forth. That review, and the NIOSH report, and any
 

changes to that report as a result of the outside
 

review would come back to the Board, be presented to
 

the Board by NIOSH with whatever consultants that do
 

it. If there's a diversity of opinions on that
 

issue, then I think -- I think it's helpful to have
 

some of those different views presented to the
 

Board, so we -- we hear about them.
 

And based on that, the Board would make a -­

make a recommendation. Now, we really -- I didn't
 

really try to get into this -- the working group
 

didn't look at the issue of what's a significant
 

change or not because the recommendation might come
 

back that after the review of the issue we may say
 

there ought to be some insignificant modifications
 

made, or ones that wouldn't sort of cross the
 

threshold of requiring, you know, Federal Register
 

notice and so forth. But the Board would make a
 

recommendation to that effect, a decision as to
 

whether or not then to go forward and with a, you
 

know, the formal Federal Register process, invite,
 

you know, the general public to review the change
 
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that's being made, if there is any change, and then
 

it would come back -- as much as we deal with other
 

regulations and so forth, come back with a final set
 

of recommendations based on what that peer review
 

show.
 

I think that -- those steps -- now, it may
 

be that the Board makes a recommendation that no
 

change should be made at all, so I think that
 

obviates the next steps. It may -- this also, I
 

think is a fairly fluid -- it would be a fairly
 

fluid process and it may be that, look, the science
 

isn't there or we need to wait and see what BEIR VII
 

does, or some other -- other particular study or
 

something that -- that -- that would come out -­

come out and we'd address this particular issue. 


There may be ongoing research or whatever, so -- so
 

there is some -- it's not always just, you know,
 

straightforward step wise, and as I said earlier,
 

some of these topics may require a longer period of
 

time. And I think it's also going to serve an
 

overall issue of what -- which NIOSH and Larry and
 

his staff have started with, was -- is they are
 

learning in this process and coming across
 

situations; at what point do they develop a new
 

procedure, how much is, you know, how big a change
 
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is that; to what extent do they want the Board
 

involved in that review, and so there may be sort of
 

different relegations of review, but I tried to
 

sketch out what would be, I think, the -- the
 

complete one. I think the key things, we're -- you
 

know, we're not an expert committee in that we have
 

-- that we really have a formal straightforward peer
 

review process to come back to, you know, capture
 

what opinions are -- are out there with the
 

appropriate scientists, and then the Board would
 

have a chance to reflect on that in terms of a
 

change in IREP, or other -- or other procedures that
 

are underway. Let me stop there.
 

DR. ZIEMER: Thanks, Jim. Why don't you -­

you can go ahead and return to your seat if you want
 

to handle questions from there, but let's see if
 

there's any questions first, or items that need
 

clarification. This actually is a workgroup
 

recommendation, so we will need to take some action. 


But let's get the questions on the floor for
 

comments or clarification, or whatever. Any?
 

Okay. There's a couple possible routes of
 

proceeding on this -- there's really two things. 


There is some recommended processes here, and then
 

there are some possible topics which, if we, in
 
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essence, say that we agree or adopt the report of
 

the workgroup, which means we are in agreement that
 

we should have a process such as the one described. 


The first part of that is taking the topics and
 

prioritizing them. There's no since prioritizing
 

the topics unless we agree that we want to do
 

something along the lines of what is described,
 

either exactly along these lines, or approximately
 

along these lines. And I -- I think it would be
 

appropriate since this is a report from the working
 

group that we can regard it as a proposed action
 

that the Board adopt this as a -- as a process for
 

dealing with IREP as we move forward. And at the
 

moment, unless I hear objections, I am going to
 

interpret this as being a motion from the working
 

group that we utilize the proposed process. Okay. 


Now, Wanda.
 

MS. MUNN: I guess perhaps I missed the
 

introductory comments, which make it a little
 

difficult for me to be very sure exactly what we're
 

recommending here. I thought I was following the
 

effort of the workgroup and what had transpired, but
 

I'm not clear exactly what the workgroup is asking
 

us to authorize.
 

DR. ZIEMER: Let me partially answer that,
 
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and then Jim can really clarify it. But this whole
 

thing arose when we said, you know, there are a
 

number of issues with IREP that may need
 

clarification. And let's take, for example, the one
 

we discussed this morning which had to do with
 

latency period.
 

MS. MUNN: I recall that.
 

DR. ZIEMER: What this process says is let's
 

identify those areas of IREP where we may have
 

ongoing concerns, or future concerns, and then if we
 

want to learn more -- we prioritize those and say
 

which are the most important ones for us to address. 


Once we do that, we ask the staff to help us
 

identify people that can be brought in to address
 

those issues, and then based on what we hear, we
 

would say well, we should do something, or we
 

shouldn't do anything, or whatever. In other words,
 

it's -- it's -- I would see it as an ongoing effort
 

to assure ourselves that IREP remains current with
 

both the science and other related issues. 


Now, Jim, help clarify.
 

DR. MELIUS: Yeah. And I think what -­

we've wrestled with this as much as with a
 

scheduling issue and a procedural issue. This is,
 

you know, it's not a top priority, I think, for
 
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Larry right now, or NIOSH, and I don't expect them
 

to be to put out a whole bunch of Federal Register
 

notices to make major changes in IREP, we're not
 

expecting that. At that same time, there's been
 

issues that have been raised that I, and I think
 

other people on the committee have requested, or the
 

Board, what should be addressed, so we're asking you
 

to in some way hear some -- some presentations on
 

those issues. It may -- may take some period of
 

time and so forth to be brought up to date of where
 

NIOSH stands with those, and so forth, and -- and so
 

part of this came out just as a scheduling issue. 


Larry is trying to figure out how to schedule Board
 

activities and so forth; what do we think are the
 

important issues; and getting -- getting them into
 

some sort of priority, so what I think what we're
 

asking -- the working group is recommending is one,
 

we look over issues, a list of issues, we prioritize
 

them; we tell -- we recommend to NIOSH these are the
 

most important issues they ought to be working on in
 

this particular area. Larry then just has to, you
 

know, obviously, balance those versus the other
 

workload and available resources and all that. 


Number two, that the procedure would be that for
 

NIOSH to do -- prepare a background report on that
 
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issue; obtain peer review or outside consultation on
 

it; and then come back to the Board with much as
 

what really Russ has -- Russ has already done, with
 

this is the problem; this is the science; this is
 

the recommended, if any, policy change or IREP
 

change that -- that would take place, or these are
 

the options for that. The Board would then make a
 

recommendation based on that of yes, you ought to go
 

forward with that, like we -- in some ways like we
 

did today; it's not a significant change, but, you
 

know, in a sense of requiring Federal Register
 

notice or whatever, or it is -- it is, this would be
 

a major change, or you shouldn't make any change,
 

this issue is just -- the science isn't there, and
 

there's not enough difference in the science or
 

change in science to warrant any change.
 

DR. ZIEMER: Keep in mind also, that this
 

process will probably occur anyway. I mean the
 

staff is always looking at IREP and saying, you
 

know, where does it need tweaking or improving or
 

whatever. The point here is for us to be working in
 

harmony with that, and also be able to say what are
 

the items that we think -- telling the staff what we
 

think are important, that may or may not be the same
 

list that they have, but, you know, I think many of
 
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these things would arise, but this makes it less
 

sort of random and makes it a little more focused in
 

terms of what we think are the -- the big issues
 

with IREP as we go forward.
 

But I don't -- I don't think it presumes, at
 

this point, any particular items, nor any particular
 

schedule, but as we go forward with this, as we
 

identify issues or as the staff does, they need to
 

come forward in a -- in a sort of organized and
 

prioritized manner.
 

DR. MELIUS: And if I could just add, and we
 

have to recognize that the claimants are going to in
 

some ways bring up issues that may need to be
 

addressed, and this issue of the other radiation
 

compensation programs because of inconsistencies or
 

differences in policy that -- that would -- that -­

say the VA adopts a different policy, then we may
 

want to take a look at that cause, you know, that's
 

certainly something that claimants or other people
 

are going to bring up, so -- and always saying this
 

is a process for doing that, it's a process that's
 

based on peer review and, you know, expert
 

consultation. I guess we're sort of being central
 

to that, and then sort of a review of that by the
 

Board after that period. 

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110 

DR. ZIEMER: Gen.
 

MS. ROESSLER: My comments change as you
 

talk because it becomes clearer. After you made
 

your presentation, I wondered how the workgroup
 

would change their approach after hearing Russ's
 

presentation this morning because it seems like your
 

list and his list are almost parallel, maybe with
 

the exception of one item. So I think what I need
 

at this point is for you to follow your
 

recommendation and make a very simple statement as
 

to -- it seems like we're doing all of this, but
 

apparently you want it more formal.
 

DR. MELIUS: No, no.
 

MS. ROESSLER: No, I -- I don't know where
 

we're going.
 

DR. MELIUS: No, I think we're begging sort
 

of one question. I think the one thing that we need
 

to do as a Board is prioritize that list in terms of
 

what needs to be worked on in the nearer future as
 

opposed to the greater future. Once we've done
 

that, then consider that list in its prioritized,
 

then we're recommending -- the workgroup is
 

recommending a procedure for dealing with that,
 

which is saying what Russ already -- some of what
 

Russ already did was, you know, with the thyroid and
 
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111 

leukemia was did a review, you know, the background
 

review; that background review is presented to the
 

Board with someone outside peer review involved. 


The extent of that peer review, I think, is going to
 

be dependent on the extent of the change, yeah, I
 

mean I'm not faulting them for not having a more
 

formal process for the thyroid and smoking, but -­

excuse me, thyroid and leukemia latency issue. But
 

the real work -- the real thing I think we need to
 

do is -- is -- that would be helpful is the -- is
 

the prioritization.
 

DR. ZIEMER: Larry.
 

MR. ELLIOTT: Let me remind the Board that
 

the regulation on probability to ways -- how we
 

determine probability of causation, which speaks to
 

modifications of IREP Section 81.12(b). That rule
 

allows the Board and other sources to recommend
 

revisions to NIOSH/IREP for NIOSH consideration. 


81.12(c) requires that NIOSH implement any 


-- that before NIOSH implements any revision of the
 

NIOSH/IREP that would substantially affect estimates
 

of probability of causation, NIOSH must obtain the
 

review of the Board and address any Board
 

recommendations arising from such review. 


81.12(d) requires NIOSH to notify the public
 
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112 

through the relevant Board meeting notice of any
 

substantial changes as defined above that NIOSH is
 

proposing for the Board's consideration and to
 

solicit public comment on such changes.
 

That's the formal process I referred to
 

earlier where we have a substantial change that we
 

would like to make or we propose to make. What we
 

presented to you this morning and in October of last
 

year were, we didn't feel, substantial changes; they
 

were fixes to those cancer risk models to make them
 

consistent with the others. This will be the formal
 

process. Certainly we could, you know, as we
 

announce the public meeting in the Federal Register
 

notice, we would announce what the, you know, the
 

substantive change would be, and how people could -­

and the public could get copies of that proposed
 

change for their review and comment. 


And I -- I agree with Dr. Melius, what I'm
 

seeking is some insight from the Board on what the
 

Board thinks are priorities in this list. Certainly
 

in my mind, in the next meeting or two we need to
 

bring NIOSH staff from another branch of NIOSH, a
 

research branch, who's been studying the DOE
 

workforce for the last 10 to 11 years to give you a
 

status report on the research studies, and what has
 
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113 

been completed to date, and what's underway, and how
 

those research studies reflect upon the list that
 

you've prepared, the list that we've prepared, and 


-- and that might be a good starting point to get a
 

sense of -- of where things are at with regard to
 

the DOE workforce, we may have a better sense of
 

what BEIR VII's coming out at that point in time as
 

well. So just for some background information, I
 

want you to understand our regulation on probability
 

of causation does prescribe a process here for us to
 

use in making changing to IREP.
 

DR. ZIEMER: So this -- this process simply
 

supplements that and just says -­

DR. MELIUS: It's just the introduction.
 

DR. ZIEMER: -- what -- what are their
 

priorities.
 

DR. MELIUS: Yeah, yeah.
 

DR. ZIEMER: Tony. Comment.
 

DR. ANDRADE: I, too, see this presentation
 

as providing us with two -- two separate topics to
 

deal with; one being the prioritization of topics
 

that we would like to hear about, okay; and inherent
 

to what I said, is the fact that this prioritization
 

does not necessarily reflect any -- or necessarily
 

any major changes to IREP. These are just simple
 
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scientific discussions that may or may not warrant
 

any further action, so that's number one. And I
 

feel that prioritization is -- is a good thing to
 

have, and perhaps other topics will come from NIOSH,
 

they may come from the public, as Dr. Melius alluded
 

to, etcetera. 


The second, I view as a transparency issue. 


The process proposed here is something that we are
 

doing already, and so to document it for the record
 

would simply provide the public especially, at least
 

an understanding of how we do review these topics,
 

and that at any point in time, we may decide okay,
 

well, this topic probably needs further attention,
 

or may warrant further investigation. But at least
 

this process will allow the public to know how it is
 

that we discuss these things. And I -- and so
 

again, I see it as a way to increase our
 

transparency.
 

DR. ZIEMER: Other comments? Wanda.
 

MS. MUNN: I believe I heard, and I think I
 

now understand, that prioritizing and establishing a
 

list of potential concerns with IREP and
 

prioritizing them would in no way constrain staff
 

from the more immediate work that they have ongoing,
 

and that would be a major concern for me; other than
 
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115 

that, I can see no reason why, with that
 

understanding, that we shouldn't proceed with the
 

prioritization and follow through with the processes
 

already established in regulation.
 

DR. ZIEMER: Larry, is that?
 

MR. ELLIOTT: (Nods head affirmatively.)
 

DR. ZIEMER: Jim.
 

DR. MELIUS: Yeah, and I would just -- I may
 

not have been clear on this, is that this is not
 

sort of a fixed process that, you know, nine topics
 

have to be dealt with in the next six months or
 

something like that. Many of these -- these are
 

issues that have been raised, they may not be
 

appropriately or should not be appropriately
 

addressed for some period of time, and it may be
 

that it's something we want to hear about at a
 

series of meetings. They're not simple issues,
 

they're not going to be resolved in one meeting or
 

one presentation, but that they would be resolved
 

over -- over a period of time, so there would be
 

some flexibility. At the same time, as Tony pointed
 

out, it would be a transparent process, so if
 

someone on the outside has questions, well, how come
 

you're not -- you haven't considered changing this,
 

or how come, you know, you're still, you haven't
 
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addressed this, you know, my concern here or
 

whatever. And you say well, there is a process;
 

we're aware of that issue; there are reasons, you
 

know, it takes time to deal with it and it may be
 

reasons that's inappropriate to address that
 

particular concern.
 

DR. ZIEMER: Any other comments?
 

What I'd like to do then is consider this a
 

motion for the Board to accept the recommendation of
 

the workgroup, and the implication of that, in turn,
 

is that we would then proceed to try to prioritize
 

the proposed list here. That would be the extent of
 

it at the moment. If you vote in favor of this
 

motion, it simply is to put on the record this
 

general procedure -- I'm calling it general because
 

it's -- it's not completely prescriptive, and then
 

to proceed with making an attempt to do some early
 

prioritization. Are you ready to vote, then, on
 

this recommendation? Okay. 


All those who favor the recommendation of
 

the working group, please say Aye.
 

BOARD MEMBERS: Aye.
 

DR. ZIEMER: Those opposed, say no. 


(No response.)
 

DR. ZIEMER: Any abstentions?
 
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117 

(No response.)
 

DR. ZIEMER: I'll declare the motion
 

carried. It would then be appropriate, if we're
 

able to, as a result of that to attempt some
 

prioritization. We can do this -- there are eight
 

topics that -- I believe there were eight on your
 

list, Jim.
 

DR. MELIUS: Yeah. Really, seven now, cause
 

thyroid we dealt with.
 

DR. ZIEMER: And we can either try to write
 

those, or an option would be, for example, to say
 

which two or three are the top priorities, you may
 

not be able to rank them, and then, you know, high
 

priority and lesser priority, you know. We could
 

have one or two, or even three categories. Well,
 

it's got to be more than one. They're all priority,
 

aren't they? 


But, Roy, you have a comment first?
 

MR. DeHART: Just a question. Is it
 

appropriate to introduce any other priorities that
 

the Board may have?
 

DR. ZIEMER: I would say yes. This is not 


-- in adopting this, this is a list that's called
 

possible topics. It would be my understanding and
 

the Chair will interpret it this way that this does
 
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118 

not preclude at any time adding additional items. 


And Jim, I think that would be the intent of the
 

workgroup, as well.
 

DR. MELIUS: Yeah.
 

DR. ZIEMER: So.
 

MR. DeHART: With that statement, I would
 

like to have the Board consider adding either now or
 

later, but I think we're all going to have to be
 

very familiar with the issue of prostate cancer
 

because that's going to be a major issue as we deal
 

with this older male population. And as you know,
 

it is a low-risk cancer for radiation, and I think
 

we're going to have to understand that and
 

understand the current science of that, and have
 

that in a form that the population at large will
 

understand.
 

DR. ZIEMER: Is there any objection to
 

adding prostate cancer issues to the list?
 

(No response.)
 

DR. ZIEMER: Without objection, that will be
 

added. Any others?
 

(No response.)
 

DR. ZIEMER: Okay. The Chair is open now to
 

having suggestions, and let's -- I'm not going to
 

ask for a specific motion -- but let's see if we
 
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119 

develop any kind of consensus what people think are
 

the top, oh, let's say three items, or your top
 

item, whichever. Let's see how it develops.
 

Wanda, do you want to start us?
 

MS. MUNN: Well, it's my understanding, I
 

think, from what Larry said that what I see is very
 

possibly the best and first item, is already
 

underway; you're already looking at the workforce
 

population studies, and we're going to be getting
 

that before very long anyway, so I would propose
 

that we accept that as our first priority since it
 

seems to be the most directly applicable to what
 

we're here to do in any case.
 

DR. ZIEMER: I believe that's the bullet
 

three, that's the incorporation of the occupational
 

studies. I think those are the DOE studies that
 

would be referred to. 


And let's hear some reaction to that. Roy?
 

MR. DeHART: No, I would agree with that. I
 

think those epidemiological studies are hard
 

drivers.
 

DR. ZIEMER: Robert?
 

MR. PRESLEY: I couldn't agree with Wanda
 

more.
 

DR. ZIEMER: You agree with that?
 
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MR. PRESLEY: I agree.
 

DR. ZIEMER: Jim. Jim? Tony?
 

DR. ANDRADE: No comment.
 

DR. ZIEMER: Others? Okay. It appears that
 

certainly that's in the high priority list then, the
 

incorporation of occupational studies. I'm not even
 

sure if that's the right set of words, but it's that
 

issue. We understand what that means.
 

MR. ELLIOTT: We would start off by giving
 

you a -- having this other research branch prepare a
 

status presentation for you, that's the starting
 

point. I think if you look at Russ's list, our
 

interest is to evaluate those finished DOE studies
 

and determine what has been learned from them that
 

is applicable to compensation practice, you know, so
 

I think that's the second step in -- in looking at. 


We need to first get you an understanding of what
 

has transpired with those research studies, and from
 

that I think will evolve, with your help,
 

identification of which pieces do we need to look at
 

a little further and evaluate for compensation
 

practice and, you know, IREP risk cancer policy,
 

those kinds of things.
 

DR. ZIEMER: Jim.
 

DR. MELIUS: Another suggestion, not
 
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disagreeing with the other one, is item number one,
 

this whole smoking issue. I think it's an issue of
 

consistency with the -- with the VA program, as well
 

as one that, as much as Roy talking about prostate
 

cancer, I think it's one that's going to come up as
 

a common concern on the part of claimants, and I
 

think we ought to be addressing that also.
 

DR. ZIEMER: It might certainly be of value
 

to know what studies are out there, and what the
 

data show on -- on smoking. There's some -- some of
 

the radon work has attempted to separate out smoking
 

and radiation exposure to the lung.
 

DR. MELIUS: And there are also some -- I
 

think that should also include some policy options
 

on how to deal with it. There's issues with the
 

classifications of smoking, as Russ brought up this
 

morning, you know, former smokers, what -- what are
 

the appropriate groups to be looking at, and what's
 

an appropriate adjustment for taking that into
 

account, so.
 

DR. ZIEMER: How do others feel on that one? 


Wanda.
 

MS. MUNN: Yes. But is this not
 

incorporated in some way in what I see as something
 

we ought to all be keeping very close track of, and
 
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that is the base-line cancer data in the general
 

population because that's -- that's one of the
 

things that's on our list, and I guess in my view,
 

the smoking issue is one that is actually a subset
 

of this cancer data in the general population. If
 

we don't look at it in that way, then we immediately
 

get into the issue of additive effects, which is
 

going to be thorny at less -- at best, and insoluble
 

at worst, and I guess I'm not arguing which should
 

come first, the chicken or the egg, it's just that I
 

see them as so closely related that the issues which
 

is -­

DR. ZIEMER: We need to understand exactly
 

how smoking is dealt with in terms of both the
 

controls and the -- and the population, for example,
 

the Japanese data versus cancer incidence in the
 

U.S. 


DR. MELIUS: Can I just say, and I think the
 

topics are two and five; five the background, and
 

two the survivor population issues there are both
 

sort of going to come up all the time. They're
 

going to come up also with the occupational issues
 

also; what's the appropriate comparisons, so I -­

and I think those may be in some ways appropriate,
 

not only to -- and they have to be -- they should be
 
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addressed with those, but also to serve as some of a
 

background, they will be hearing more about those
 

issues and in general, not necessarily having to
 

take action on them directly, but maybe doing so in
 

terms of smoking and occupation.
 

DR. ZIEMER: By five, you're talking about
 

incorporation of background cancer risks?
 

DR. MELIUS: Yeah, yeah.
 

DR. ZIEMER: Roy.
 

MR. DeHART: Yes, I'd like to move back with
 

the smokers. I think as we all know, lung cancer is
 

the number one cancer killer now among both male and
 

female populations, consequently we're going to see
 

a lot of lung cancer. And the population we're
 

dealing with, the estimated number of smokers, past
 

smokers, are going to be running between 40 and 50
 

percent, so when we compare that to the number of
 

lung cancers we're going to have, this is going to
 

be a major issue, and I think we really need to know
 

the science on this.
 

DR. ZIEMER: There seem to be nods of
 

approval, so we can consider that as a high priority
 

item. For the time being we're calling that maybe
 

second. 


MR. GRIFFON: I was grouping those as one.
 
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DR. ZIEMER: Priority one -- priority one. 


I'm wondering if it wouldn't be helpful to identify
 

at least one third one and call that, you know, talk
 

about our top three as priority one items, so we
 

don't get into details on language. 


Robert, do you have a -­

MR. PRESLEY: Number six, miscellaneous
 

cancers. 


WRITER/EDITOR: Use the mike, please.
 

MR. PRESLEY: Number six, miscellaneous
 

cancers. Should we not go ahead and start looking a
 

little bit more at that before it gets -- bites us
 

down the road?
 

DR. ZIEMER: Is that the one -- excuse me,
 

for clarification on the slide, is that the one that
 

is -­

MR. PRESLEY: The rare cancers.
 

DR. ZIEMER: -- the rare cancers.
 

DR. MELIUS: There's issues of grouping, as
 

well as what's been created and so forth, and so
 

there's, I think, some sort of technical issues that
 

come up with that. 


DR. ZIEMER: Robert, so you were suggesting
 

that that be -­

MR. PRESLEY: Yes.
 
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DR. ZIEMER: Others, comments on that? Or
 

if you have something else you think is a higher
 

priority you can say something.
 

Yeah, Richard.
 

MR. ESPINOSA: I'm not necessarily -- I'm
 

not necessarily in disagreement, but I do think age
 

at exposure probably should be within the top three
 

or four.
 

DR. ZIEMER: Okay. Thank you. Mark?
 

MR. GRIFFON: I guess I was just going to -­

the three I have was the smoking, the incorporation
 

of the background cancer risk -- and I think Wanda
 

and -­

DR. ZIEMER: To some extent that gets linked
 

with the smoking, so.
 

MR. GRIFFON: Right. And then the worker
 

studies, those three grouping within one level. 


DR. ZIEMER: Any other comments? Let me
 

suggest the following to speed this up a little bit,
 

so. Kind of link smoking and incorporation of
 

background together as a kind of a combined topic,
 

so the age at -- I'm sorry, the incorporation of
 

occupational studies number one; the smoking and
 

background cancer risks are the second one in the
 

group, not necessarily in rank, but top priority;
 
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and the rare or miscellaneous cancers the third one
 

in that group; and then the only other one that's
 

been mentioned is the age at exposure. Do you want
 

to include that in the top list or -­

DR. MELIUS: Only in that I think that takes
 

some time to get briefed on and developed and so
 

forth, and I think -- I think it's important to
 

start on it. I don't think we necessarily expect to
 

resolve anything with that, whereas maybe with some
 

of these others will be.
 

DR. ZIEMER: Perhaps we can agree that maybe
 

that one would be the top of the second priority 


of -­

MR. ESPINOSA: That's fine.
 

DR. ZIEMER: Is it agreeable right now to
 

have first priority and second priority, and have
 

those -- those first three topics, and then we put
 

this next one at the top of the second priority? 


I'm not sure it's useful for us to try to rank
 

things in any more detail beyond that. We have the
 

list and we can always revisit it at some point if
 

something rises to the top, we just identify that
 

and say let's go ahead and look at this. There's no
 

real value spending much more time on it.
 

DR. MELIUS: Bob just made a good point on
 
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the BEIR VII like at the age of exposure, the
 

survival -- all the -- I think BEIR VII may address
 

that issue to some extent. We certainly will be
 

waiting for BEIR VII before we address this.
 

DR. ZIEMER: Right. Roy.
 

MR. DeHART: Yes, I'd like to suggest if
 

we're doing a second priority that we put prostate
 

in there because -­

DR. ZIEMER: Oh, I'm sorry.
 

MR. DeHART: -- I don't want it to wait too
 

far down the line.
 

DR. ZIEMER: Right. 


DR. ANDRADE: Paul?
 

DR. ZIEMER: Yeah.
 

DR. ANDRADE: I was going to suggest that we
 

include prostate cancer as part of the miscellaneous
 

cancer group. That goes up in the first priority.
 

DR. ZIEMER: Yeah, because the rare types of
 

cancer -­

DR. MELIUS: That's -­

DR. ZIEMER: -- no, for radiation, what's
 

considered for radiation on that perspective. So
 

we'll agree that prostate is in that category. 


Thank you.
 

Is there -- Wanda, please.
 
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MS. MUNN: We might keep in mind that with
 

the current emphasis on understanding and treating
 

prostate cancer in the general population, we
 

probably will get a great deal of basic information
 

on that when we get base-line data as well.
 

DR. ZIEMER: And these are not all mutually
 

exclusive -­

MS. MUNN: No.
 

DR. ZIEMER: -- and there will be overlap,
 

I'm sure, in any event. So can we pretty much agree
 

on these without a formal vote that these will be
 

our priorities for the moment?
 

MS. MUNN: Yeah.
 

DR. ZIEMER: I think we came to agreement on
 

that. Thank you, Jim, and our working group for -­

for your work on that particular item. 


We're going to break in just a few moments.
 

MR. ELLIOTT: At the risk of belaboring
 

this, I just want to make sure that you take a look
 

at the research needs that Russ presented and make
 

sure that if there's something there that you want
 

to put in one of your two priorities, you tell us
 

now. I think there's several, you know, hits here,
 

duplications, if you will, from one list to the
 

other, but there are some things here that doesn't
 
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appear on both. 


DR. ZIEMER: Jim, did you -- did you cross-


calibrate those and see what -­

DR. MELIUS: No, these were independently
 

developed.
 

DR. ZIEMER: All right. I'm looking for the
 

-- are there some that jump out from his list 


that --


MR. ELLIOTT: Well, the risk of transfer
 

from the Japanese cohort, I don't think was on 


Dr. Melius' list.
 

DR. ROESSLER: That's -- that's the one the
 

public brings up all the time. I think it needs to
 

come up before this Board in a public forum to
 

address it, although we might have to wait for BEIR
 

VII for it.
 

DR. MELIUS: That was, I think sort of
 

generally, this whole issue of applying the
 

Japanese, how it's applied, so the dose -- dose
 

issue, a whole number of issues have come up there
 

and they're included in the sort of subtopics. And
 

again, I think BEIR VII may preclude us from doing
 

much now. The last item on Russ's list, Interaction
 

with other workplace exposures, to some extent is
 

outside our purview now, though I think it will come
 
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up sort of dealing with the occupational workplace
 

situation because as we get it presented by NIOSH,
 

their studies have to address that issue also.
 

MR. ELLIOTT: So is it fair to say that you
 

would put that in -- into the second level priority? 


And what about the skin cancer bullet, or do you see
 

that? Second level?
 

DR. ZIEMER: Can we -- can we agree that we
 

would include Russ's topics into our list?
 

MS. MUNN: Yes. Uh-huh (affirmative). 


DR. MELIUS: Yeah.
 

MR. ELLIOTT: And I don't know if Russ had a
 

comment, or -­

DR. ZIEMER: By not naming them here doesn't
 

mean there's no interest. 


Okay. Russ.
 

MR. HENSHAW: Yes, thank you. I just want
 

to mention that regarding the item on my list, I
 

think it's on your list too, on DDREF we have
 

authorized David Coker, who is under contract with
 

SENES to continue working on that issue, and they
 

are in fact working towards submitting that for
 

publication, and seeking peer review, and we've
 

asked and funded SENES to respond to whatever
 

criticisms arise from the peer review process.
 
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131 

DR. ZIEMER: Thank you. And I think we
 

should make it clear that even if something may not
 

have risen to the top of our list right now, that
 

doesn't preclude the staff bringing it forward as -­

as information becomes available.
 

MR. HENSHAW: Dr. Ziemer, let me just
 

clarify. Primarily focusing on the radiation
 

effectiveness factor is the paper that Dr. Coker
 

presented to the Board.
 

DR. ZIEMER: Right.
 

MR. ELLIOTT: I appreciate this. This helps
 

me understand what your interests are so that I can
 

marshall the resources to put it together for you,
 

so we will balance that all out.
 

DR. ZIEMER: Thank you. Before the lunch
 

break I just want to let the Board members know, and
 

the members of the public as well, that I've been
 

given a list of recommended dining. I think these
 

are -- these are all restaurants in the near
 

vicinity. I'm not sure who is recommending them. I
 

don't know if this is Robert Presley's
 

recommendation, or if this is the local -- local
 

Chamber of Commerce, or these are the local
 

restaurants who anteed up to get on a list or what,
 

but anyway there is a list of restaurants, but it
 
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doesn't tell where they're at.
 

The lunch break goes till 1:30, so we'll see
 

you all back here then.
 

(Whereupon, a luncheon recess was taken.)
 

///
 

BY DR. ZIEMER: (Resuming)
 

Well, we'll come back into session even
 

though not everyone is here yet, but we want to move
 

along. 


We're pleased to have Dr. Sergio Bustos here
 

this afternoon. He is Professor Emeritus at the
 

Medical College of Georgia in Augusta. Dr. Bustos
 

came to the U. S. originally as a Fulbright Fellow,
 

and he's a graduate of the University of Chile in
 

Santiago, and also was a graduate at one of the
 

programs at the University of Rochester as well. 


Dr. Bustos is former Professor of Physiology at the
 

University of Concepcion in Chile; he was also a
 

Professor of Bio-Chemistry at the Medical College of
 

Georgia. He has served as a consultant to the World
 

Health Organization, and he's recently, since '95
 

really, been Chairman of the Savannah River Site
 

Health Effects Subcommittee. And we're pleased to
 

have Dr. Bustos here this afternoon to tell us about
 

the Savannah River Site Health Effects Program.
 
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133 

DR. BUSTOS: Thank you very much. Can you
 

hear me?
 

DR. ZIEMER: There's a little on/off switch
 

on that. Make sure that that's.
 

DR. BUSTOS: I think now it's on. 


Thank you very much for the invitation to
 

attend this meeting on the Advisory Board on
 

Radiation and Worker Health, and to tell you
 

something about what we do at the Savannah River
 

Site Health Effects Subcommittee. Through your web
 

site I already got acquainted with your mission and
 

your activities. 


I became interested in the effects of
 

radiation working precisely with radiation. I spent
 

a large fraction of my academic life working with
 

Potassium, Beryllium, Calcium, Iodine 131, S35, C14,
 

Tritium, etcetera, so I think I qualify as a worker;
 

so this is what qualifies me to appear before you
 

here.
 

In addition, my specific area of research
 

and teaching was nucleic acids and proteins, which
 

are the prime targets for radiation. In 1995, the
 

Savannah River Site Health Effects Subcommittee was
 

established for the purpose stated here: To
 

identify the needs of exposed and potentially
 
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134 

exposed populations around the Savannah River Site. 


And one of the functions is to make recommendation
 

to CDC, and acts in an advisory capacity to NCEH,
 

NIOSH, and ATSDR, and also evaluates the research
 

and public health activities at the sites. 


The SRSHES Membership, it's a very
 

heterogeneous group; it consists of engineers,
 

scientists, physicians, workers, nurses, housewives,
 

it covers the whole spectrum. And these are, of
 

course, individuals that are selected by the federal
 

agencies, and what they bring is their experience or
 

their -- and their scientific knowledge. And in a
 

way it reflects the demographics of the area. 


The -- the mission of the Savannah River
 

Site was to study the potential health effects that,
 

of course, are due to the releases of radioactive
 

and hazardous material, radionuclides or chemicals
 

from the Savannah River Site, and their site
 

election would be the offsite population and the SRS
 

workers. The -- we've had since 1995 -- I just
 

can't believe that I have been the Chairman since
 

1995. The other day I went to CDC and I introduced
 

myself to people saying I'm the Chairman for life of
 

the SRSHES. But I think of this as this may be one
 

of my last appearances. 

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135 

Among the activities that we have undertaken
 

are presentations; summaries; proposals; projects by
 

the agencies; have recommended changes in the peer
 

review protocols used by agencies; advised the -­

the firm, the organization that conducted the dose
 

reconstruction on the Savannah River Site, that's
 

the RAC on Phase I procedures of the dose
 

reconstruction procedures. We developed a brochure
 

where the mission of the committee was spelled out;
 

the functions, the compositions, the aims. At one
 

point we instituted a toll-free line to -- for the
 

people outside to have access to us and tell us what
 

their concerns were; provided input to the Advisory
 

Committee for Energy-related Epidemiological
 

Research, ACERER. As a matter of fact, two of our
 

committee members attended the meetings of ACERER;
 

participated in Phase I and II of the Reconstruction
 

Project, and by this, I mean participation, actual
 

participation. We reviewed, or we went to the
 

place, to the vaults of where the archives, where
 

all the boxes, I think there were 50,000 in all,
 

that were kept in the vaults of the Savannah River
 

Site, and we were given special clearance, so we
 

walked and opened, and saw many of the contents of
 

them, and this was a daunting task for the
 
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organization that was conducting the Dose
 

Reconstruction Project. And so a modus operandi had
 

to be established, and we participated in advising
 

the -- the experts that were conducting the Dose
 

Reconstruction Project on how to go about it. And I
 

think that that simplified their task. 


We are now in the process of analyzing, or
 

rather, participating in developing the scenarios
 

for radionuclide screening analysis. Following the
 

Phase I, which was the search for the historical
 

records of the Savannah River Site that I just
 

explained to you, we also participated in the -- in
 

Phase II, which was the definition of the source
 

term and the pathways for contamination, the
 

atmospheric and the water pathways, the kinds of
 

radionuclides that escaped from SRS. And that
 

resulted in -- in a book that was very, very heavy,
 

about this (indicating) size, and this (indicating)
 

thickness. I cannot remember exactly how many pages
 

it had, but it must have had close to 800 or so
 

pages, with many chapters which the experts had
 

spelled in detail the equations and graphs, and
 

their recommendations. And we divided the
 

committee, this committee was divided into people
 

who would review chapter by chapter, so we undertook
 
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the task of correcting it, correcting the graphs;
 

establishing whether there was clarity in the
 

graphs; correcting the footnotes; the syntax, the
 

explanations of this, rather, topic. And that was
 

something that took about a month where we met at
 

different places in Georgia and South Carolina. And
 

following that, we are, at the present time,
 

assisting in developing the scenarios for
 

radionuclide screening. 


Now, in one of our meetings we devised a
 

strategic plan for Phase II that has to do with the
 

epidemiological considerations. And the
 

radionuclide screening was going to be done by staff
 

at the CDC, and the chemical screening was going to
 

be done by a contractor; but because of changes in
 

priorities, the screening of radionuclides would
 

also be done by a contractor. That has to do with
 

the change in the focusing of CDC into bioterrorism. 


What is the, our committee's role in this? 


It's participate in the developing of exposure
 

scenarios; participate in the development of risk-


based ranking criteria; and participate in decisions
 

on what future work lies ahead or is needed. And
 

the first thing that we embarked on is the refining
 
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138 

and the fine tuning of the generic families that
 

would constitute the population that lived around
 

the Savannah River Site. And for this purpose there
 

are six families, six categories that have been
 

proposed. The first one is a rural family that
 

lived just downwind from the site boundary; the
 

second one would be an urban or suburban family just
 

downwind of the site boundary; the third category is
 

a migrant worker family living mostly outdoors; the
 

fourth category would be a family that lives in a -­

in a boat in the Savannah River Site. I have to
 

remind you that the Savannah River Site occupies 310
 

square miles in the boundary between Georgia and
 

South Carolina, and so the Savannah River Site flows
 

at the boundary. And as a matter of fact, the -­

the -- the small creeks and little rivers inside the
 

Savannah River Site drain onto the Savannah River,
 

so it's very proper that we do -- that we suggest
 

this family living on a boat on the river; then a
 

person living nearby that, in addition to that,
 

makes deliveries to the river -- to the Savannah
 

River Site, or people who catch beavers; and
 

finally, an outdoors person who is fund of hunting
 

and fishing, camping, etcetera. So for each of
 

these family we are developing what are the
 
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conditions that we're going to impose on it. 


I am going to give you one of the examples
 

that we have come up with. For the rural family
 

scenario, that, we would have to choose the
 

location, that's the closest downwind location where
 

there could have been farms in 1955. The -- the
 

number of adults, infant born in 1955, an infant
 

born in 1964. Why 1964? Because that's the year of
 

the highest release of radioiodine. We have to use
 

the consumption values to make us take into
 

consideration the -- the time that is spent outdoors
 

and working in the soil, whether the family drank
 

fresh milk from a backyard cow, and whether their
 

crops were irrigated from the Savannah River Site. 


So for each of the other categories that I described
 

for you, we are going to establish what the main
 

criteria, the main characterizations. 


And finally, we also have the -- the public
 

involvement that participates by attending our
 

meetings, sharing ideas with the members of the
 

committee, sending concerns and questions, signing
 

onto SRSHES mailing list. 


And one thing that I neglected to tell you
 

is the way that we conduct our meetings. And we
 

started first following the -- the Roberts Rules of
 
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Procedure, but they were disposed of, in a manner of
 

saying, by the Bustos Rules of Procedure, which are
 

very similar to the ones that you use here, and
 

that's that we allow people to express their
 

opinions ad nauseam. I guess I exaggerate. I guess
 

I took the liberty of exaggerating it a little, but
 

it's -- but what we do is very similar to what you
 

do. So, any questions?
 

DR. ANDRADE: Dr. Bustos, after hearing
 

about your background both in the academic arena and
 

in working on this Subcommittee, I imagine that
 

you've had a chance to -- am I speaking loud enough
 

-- okay -- I imagine you've had a chance to ponder
 

the whole question of the combination of potential
 

effects from radiation and hazardous materials. 


Have you formed any opinion, come to any
 

conclusions, have anything that might provide a
 

vector for this -- for this Advisory Board on
 

whether there is fruit somewhere in scientific
 

studies on the combined effects? Is it -- is it
 

possible to distinguish between the effects, or have
 

you seen, for example, they may be additive, they
 

may be multiplicative, that sort of, or would we
 

just be barking down -- just going down a path that
 

will never bear fruit if we start to look at that
 
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arena?
 

DR. BUSTOS: Well, I can tell you that my
 

opinion, when I said that I was a worker, when I was
 

working with radiation, that has to be very, very
 

well qualified because I was -- I was working, but I
 

was following very specific and carefully prepared
 

protocols and had all the shields and all the
 

protection that was needed. But I can tell you that
 

when I -- when I started I was counting gamma
 

radiation in a counter on Sunday evenings, Sunday
 

afternoons without any protection whatsoever, none. 


I had a mixture of beryllium, calcium and potassium,
 

and we were separating these isotopes after they had
 

passed through the heart to the myocardium of a dog,
 

so I have the -- I have that excuse, so I became
 

very sensitized to that aspect. Of course, you
 

know, in -- in the workers realm I do not believe, I
 

don't have first experience, but I think that those
 

protocols that we used in the lab are not followed
 

exactly in the same way. So there is, I think,
 

ample ground, you know, to investigate whether the
 

effects are multiplicative, cumulative, etcetera,
 

etcetera; you will not -- you will not be barking in
 

the wind.
 

DR. ZIEMER: You mentioned the membership of
 
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your group including engineers, scientists,
 

physicians, general public. What's the total size,
 

numerically, of your Committee and Subcommittee? 


How many people?
 

DR. BUSTOS: How many? We have -- it
 

differs depending on the -- on the time, but we
 

currently have 18 members.
 

DR. ZIEMER: That's the full Committee?
 

DR. BUSTOS: That's the full Committee, but
 

the Memorandum of Understanding allows us to have 30
 

members, but because of medical considerations,
 

among them, many-headed monsters would not work
 

well, so it was -- it was agreed that a Committee of
 

18 would be the most suitable. Of course, all of
 

this is based on empirical experience. 


DR. ZIEMER: And Dr. Roessler has a
 

question.
 

DR. ROESSLER: You mentioned earlier in your
 

talk that the Committee is interested in potential
 

health effects and on one of your slides you have
 

the offsite population, and you also have the
 

workers. From what you've said though, I -- I
 

assume that the dose reconstruction was primarily on
 

the off-site populations.
 

DR. BUSTOS: Yes.
 
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DR. ROESSLER: But have you done any work
 

then on the dose reconstruction for workers?
 

DR. BUSTOS: No, we have not.
 

DR. ROESSLER: Okay. 


DR. BUSTOS: But it is a concern of the
 

Committee and theoretically, if the issue is brought
 

before us and we have people who have worked at the
 

Savannah River Site who appear before our Committee
 

relating their experience, and the ailments that
 

they have been affected with, naturally the -- the
 

doses that were established for the offsite
 

population will also apply in-site too.
 

MR. DeHART: Roy DeHart. Is there anyone
 

that's going to go over a little about the Savannah
 

River Site in terms of its operation to the degree
 

that it can be discussed around the table?
 

DR. ZIEMER: Physical description of the
 

site and the activities there?
 

MR. DeHART: Yes. He mentioned the size,
 

which is quite considerable. We have two -­

DR. ZIEMER: I noticed there was -­

MR. DeHART: We have two overheads.
 

DR. ZIEMER: -- was handouts. I'm not sure
 

of the source of those. Are these -­

DR. BUSTOS: Yeah, I -­
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DR. ZIEMER: Can you talk a little more
 

about the -­

DR. BUSTOS: -- I have provided two of
 

these. If we can put the -- if we can set up the
 

overhead projector. 


Yeah, the -- the heart -- the heart of the
 

Savannah River Site is constituted by the -- by the
 

five reactors and the chemical separations. And
 

adjacent to it there was an area where the fuel
 

targets were prepared. And adjacent to the area
 

there was also heavy water -- heavy water plant. 


This heavy water plant had the function of using the
 

Savannah River -- Savannah River water and
 

converting it to heavy water. That heavy water was
 

needed as a coolant in the reactors. Now, the heart
 

of the Savannah River Site is the five reactors,
 

R,P,L,C,K. And the Canyons, the H-Canyon, and the 


F-Canyon that are the chemical -- where the chemical
 

separation is produced, and here (indicating) is the
 

heavy water plant that provides the coolant for the
 

-- for the reactors. By the way, all the -- all the
 

reactors are deactivated now, so -- and then the
 

chemical separation that takes place in the Canyons,
 

in the absence of a presence of humans, by the way,
 

there is waste, there is chemical waste and there is
 
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radioactive waste that is generated. And this is
 

then taken -- or was taken to tank farms or to other
 

areas that are called seepage basins and the Z-area
 

with saltstone. So this is where the area, the 


M-area where the reactor components, fuel and
 

target, were assembled, then they were taken to the
 

reactors. And the function of the reactors, during
 

the Cold War, and post-Cold War, was to produce
 

plutonium and tritium. That was the main. So
 

that's in a nutshell, that's a -- that's a lot, you
 

know, there would be a whole lecture to give on the
 

subject, but that would be SRS in a nutshell.
 

One of the activities of the Committee that
 

I neglected to -- was to tell you that when the face
 

tube, the analysis of the source term and the
 

emission of radionuclides was taking place, then the
 

Committee helped determining what area would be the
 

area that was going to be used for the sampling, for
 

the analysis. And that was an area larger than this
 

(indicating) one because this is the -- this is
 

simply the -- the area of the plant with the five
 

reactors, the C,K,L,P,R and the Canyons, the 


F-Canyon and the H-area that where the chemical
 

separation was. And they are all strategically
 

positioned within this (indicating) circle; whereas
 
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the -- the M- and A-areas, that was the fuel and
 

target fabrication areas, and the heavy water areas
 

were way apart. This (indicating) is 310 miles;
 

this (indicating) is the Savannah River Site; and
 

these are the streams that flow from the interior of
 

the Savannah River Site to the Savannah River. 


Again, this is a very, very brief summary of
 

what could be said on it.
 

DR. ZIEMER: Thank you. Other questions?
 

MR. GIBSON: Doctor, you mentioned that you
 

guys went through the historical records in the
 

vaults and you looked back at how they performed
 

their analysis on some of their monitoring they had
 

done and stuff. How valuable do you think that was
 

to your research on -­

DR. BUSTOS: Excuse me. I lost track on
 

that.
 

MR. GIBSON: Okay. 


DR. BUSTOS: Would you start again?
 

MR. GIBSON: You mentioned that you had
 

looked through vaults and historical -­

DR. BUSTOS: Vaults, yes.
 

MR. GIBSON: -- records -­

DR. BUSTOS: Yes.
 

MR. GIBSON: -- and looked at how they had
 
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147 

done their analysis and -­

DR. BUSTOS: Exactly.
 

MR. GIBSON: -- kind of recreated them.
 

DR. BUSTOS: Yes.
 

MR. GIBSON: How much value do you put on
 

that in ascertaining a dose that a population might
 

have got?
 

DR. BUSTOS: Oh, that was invaluable. It
 

was inventory, you know, when hydrochloric acid
 

came, nitric acid came, all the chemicals that came
 

to the plant. And then everything that was -- that
 

-- that was annotated was contained in there, so it
 

was a very -- that was a sine qua non starting
 

point.
 

MR. GIBSON: So did you find any anomalies
 

when you recreated these -- these analysis and had
 

other people look at them, or?
 

MR. BUSTOS: No -- no anomalies were found,
 

except that it was -- at one point there was a
 

closely kept inventory, and at other times there was
 

not as well kept as would have been desirable. But
 

that was -- that was corrected by interviewing the
 

people who were in charge of that, and were retired
 

people who were still around who volunteered to
 

provide information on precisely the missing parts.
 
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148 

MR. GIBSON: Thank you.
 

DR. BUSTOS: So -- so there was oral and
 

written history. 


DR. ZIEMER: Has the research agenda of the
 

groups that you advise changed as a result of your
 

reviews? I noticed that you evaluate the adequacy
 

of their research activities. Has what you've done
 

caused them to change direction, change priorities,
 

change research designs?
 

DR. BUSTOS: Well, throughout the dose
 

reconstruction period, that took several years, the
 

scientists who were conducting this, chemists,
 

biochemists, nuclear scientists, etcetera, appeared
 

before the Committee and provided us with a step-bystep detail of what they were doing. And they were
 

subjected to a question period, very, very intense,
 

that ranged from the scientific part to sometimes
 

the social aspects, the community aspects. So the
 

Committee was involved not only in being apprised of
 

the -- the rate of the project, but as of the
 

particulars, and they were asked in detail to
 

specify what -- what it meant, not -- you know,
 

because of the heterogeneity of the -- of the
 

Committee, some of the members did not have the -­

the knowledge, but they had common sense and they
 
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149 

asked to be explained in terms that were very clear,
 

understandable, the meaning of what being said,
 

whether it was Owen Hoffman from SENES to John Teal,
 

everyone was required to explain in detail and very
 

clearly what had transpired. And because of that,
 

you know, at the end of the Dose Reconstruction
 

Project, then there was a summary, an account, of
 

what had been done that had to be understandable for
 

people who have very little knowledge, which was a
 

very difficult thing to do, by the way.
 

MR. ELLIOTT: I think one of the
 

accomplishments that you point to here in response
 

to Dr. Ziemer's question, the change in peer review
 

process that your Committee effected across the
 

three agencies, ATSDR, NCEH, and NIOSH, in my
 

opinion that was quite an accomplishment and it
 

effected some changes in how we, in the agencies
 

worked, and how we got peer review on our individual
 

research projects. Would you -- would you agree
 

that that -- I mean you highlighted it earlier, but
 

I think it's something that answers Dr. Ziemer's
 

question in a way.
 

DR. BUSTOS: Yes, exactly. 


MR. ELLIOTT: Just so the Board understands,
 

there are four subcommittees, and as the Board goes
 
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150 

around having your meetings at different sites we
 

would intend to invite the other Chairs of the other
 

three. There's a subcommittee in Oak Ridge that was
 

just recently established within the last couple of
 

years, they don't have the tenure that Dr. Bustos
 

has. There's another -- that subcommittee is
 

sponsored and administered by the ATSDR, Agency for
 

Toxic Substances and Disease Registry. Dr. Bustos'
 

committee is sponsored and administered by the
 

National Center for Environmental Health. The
 

committee -- subcommittee at Hanford is sponsored
 

also by the ATSDR, and it's been in existence the
 

same time frame that yours started, I believe, 


Dr. Bustos. Then the fourth committee is out of the
 

Idaho National Engineering Lab, and they were also
 

in existence from the very start when Dr. Bustos'
 

committee came on line, and it is also sponsored by
 

NCEH. 


DR. BUSTOS: Any other questions or
 

comments?
 

DR. ZIEMER: Thank you, very much. That's
 

been very informative for us and we appreciate your
 

being with us today.
 

DR. BUSTOS: You are very welcome.
 

DR. ZIEMER: Our next Agenda item is one
 
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151 

that, in a sense, carries forward from the past, and
 

that is the area of the Board's review of dose
 

reconstructions. I want to refer you, first of all,
 

to the material under the tab called Discussion
 

Documents, which includes the current version -- or
 

versions of the various parts of the Request for
 

Contract that has been developed through our
 

workgroup. And then there's a summary of the slides
 

that were used this past -- was it in July --


DR. ROESSLER: Uh-huh (affirmative). 


DR. ZIEMER: -- past July. And to begin our
 

-- well, let me make a few remarks, sort of
 

preliminary remarks, and then Larry, we'll let you
 

make some remarks and I want to call on Mark Griffon
 

as well. But you -- you recognize that we -- at our
 

last meeting we had the closed session dealing with
 

issues around the Request for Contract. I'm going
 

to ask Larry to give us an update on that process. 


We also need to get some thought about how we need
 

to position ourselves as a Board, so that we're
 

ready to go at the point at which the Contract is
 

ready to go; what will our review process be; how
 

will we be structured as a Board to carry out and
 

conduct the reviews themselves with the assistance
 

of the contractor that is chosen.
 
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152 

But, Larry, why don't you give us a quick
 

update first on the -- the procurement process.
 

MR. ELLIOTT: Sure. First of all, let me
 

say that the document you have in your briefing
 

booklet under the tab that Dr. Ziemer pointed out to
 

you that says Draft 01/ -- whatever the date is on
 

there -- that is the document that we understood you
 

all to have reached consensus on and passed at your
 

last meeting in Cincinnati in January. 


It is certainly -- you still have an
 

opportunity, this document has not gone forward into
 

the procurement process as of today. We need to
 

have from you some -- some clear direction at this
 

point on how you would want to proceed, and I will
 

get into that in a moment, but I'd like to say at
 

this point you still have an opportunity to make or
 

effect any further changes before this procurement
 

is initiated. This is your last opportunity to do
 

so. We -- and again, we have not put it into the
 

procurement process for this reason: We -- we left
 

the January meeting and having heard a few of the
 

Board members -- I didn't hear a consensus in this
 

regard, but I -- and I heard people speak to the
 

other side of this issue as well -- but that NIOSH
 

was in a situation here where there could be a
 
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153 

perceived conflict of interest with your audit of
 

our work being procured for technical consultation
 

to assist you in that being procured through NIOSH. 


So I took that discussion to heart, I heard, you
 

know, I heard what certain Board members had to say
 

and what members of the public had to say in that
 

regard, and I went back to my principals and talked
 

about it and offered a suggestion to them that could
 

we not find a way to put some distance between NIOSH
 

and the effecting the award of this procurement, and
 

the administration of this procurement. I proposed
 

to -- to Dr. Howard that -- who is the Director of
 

NIOSH -- that perhaps, you know, we could seek
 

another agency to -- to handle this procurement for
 

the Board. I then approached and had some
 

discussions with Mr. Pete Turcic, and I think he's
 

in the audience. Pete's back there. He -- he's my
 

counterpart at the Department of Labor. He's the
 

Director of the -- of their Compensation Program on
 

this -- on this Act, and talked to Pete about
 

whether or not it made any sense for, in his mind,
 

for DOL to effect this procurement and make the
 

award, or whether there was another option. And we
 

-- we talked about that at length. We have pursued
 

other agencies as an option; we talked about the
 
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154 

General Services Administration. So what we boiled
 

down to is a decision for you all to make, and that
 

is whether you would prefer that the Department of
 

Labor effect the award of this Contract and
 

administer the Contract, or you'd just as soon see
 

NIOSH retain it and make the award, and monitor the
 

progress and make sure that, you know, we were
 

working in your best interests. 


We've -- you know, in our deliberations we
 

identified that the other agency options were not a
 

viable option in that we could not make sure that
 

they would give due diligence in the processing of
 

this particular procurement, so that's where it
 

stands. It is not -- we've wrapped it all up, it is
 

in the form of a -- what we call an RFP, Request for
 

Proposals. I need to hear from you all what your
 

consensus is with regard to whether NIOSH should
 

effect this RFP and administer the award, or whether
 

you think that the Department of Labor makes more
 

sense to do so. So I would welcome your -- your
 

discussion in that regard, and your direction.
 

DR. ZIEMER: I wonder if it would be of any
 

value to the Board to also hear from Pete on this
 

issue from Labor's perspective. Maybe Pete will
 

tell us why it should go to NIOSH and NIOSH will
 
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155 

tell us why it should go to Labor.
 

Pete, if you're willing to come and address
 

the Board a little bit about how this would look
 

from your perspective and anything you think we
 

should know in terms -­

MR. TURCIC: Okay. 


DR. ZIEMER: -- of that issue.
 

MR. TURCIC: Sure. In my discussions with
 

Larry, the way we would envision that if DOL were
 

to, you know, handle the procurement and then the
 

ongoing coordination of the task orders, we would
 

basically do it in a manner where we were the
 

administrative arm of the Board for managing that
 

contract. We would have -- we envisioned that we
 

would have our office of the Assistant Secretary for
 

Administration and Management handle the procurement
 

in, you know, with naturally, you know, having
 

individuals on the procurement, on the evaluation
 

board, on the evaluation team, and then just
 

administratively carrying out that procurement. And
 

then following that, we would envision a system
 

where within the Department of Labor we would have a
 

liaison to coordinate -- any of the task orders
 

coordinate with the Board, so it wouldn't be that we
 

-- I guess the technical term would be the
 
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156 

contracting officer's technical representative, but
 

it really wouldn't be -- it would be more of a
 

administrative representative where the task orders
 

would come from the Board, then those task orders
 

would then be implemented and put into the system 


and tracked, and from an administrative standpoint
 

DOL would merely be fulfilling a function of being
 

the administrative arm for providing that kind of
 

contractual services, you know, to the Board for
 

that process. From DOL's perspective, the -- it's
 

very important that the work of the Board in this
 

overview and function is very important to us in
 

maintaining the integrity of -- you know, we have to
 

adjudicate if -- if there are issues that come up,
 

that people raise issues concerning the dose
 

reconstruction process where that is adjudicated is
 

after the claimant gets a recommended decision; so
 

the, you know, from that perspective the quality
 

control function that the Board will be, you know,
 

carrying out in this process is extremely important
 

to DOL, and we would do whatever, you know, whatever
 

makes sense for administratively carrying this
 

function out.
 

DR. ZIEMER: Larry, do you have some
 

additional comments?
 
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157 

MR. ELLIOTT: Well, suffice it to say that
 

if -- if it was NIOSH carrying forward this
 

procurement and processing the procurement we would
 

do everything in due diligence and with the same
 

amount of interest and effort that Pete has just
 

described to you as well, so. We talked about
 

having a, you know, a technical liaison from NIOSH
 

work with whoever their technical project monitor
 

would be for the contracting officer. The Board
 

would create its task orders, and whether it was run
 

through the NIOSH procurement system or the Labor
 

procurement system, I don't think there's any
 

difference in the process, the sequence of events,
 

or the amount of effort that would be accorded to
 

this -- this whole procurement.
 

MR. TURCIC: Hey, Larry, in some of the
 

earlier discussions, one other piece of it, there
 

was a question came up about, you know, how DOL
 

would interact with the Board and with NIOSH, and
 

one way to address that would be a Memorandum of
 

Understanding specifically for, you know, for this
 

project. 


DR. ZIEMER: Provided such Memorandum could
 

be developed at a more rapid fashion than others.
 

MR. ELLIOTT: I think we could do that.
 
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158 

DR. ZIEMER: Now, could either of you, or
 

others help me get a feel for the extent to which
 

conflict of interest could still be perceived? This
 

is also a Department of Labor program insofar as
 

they do make the final decision on adjudication of
 

the claims, so I'm trying to get a feel for what we
 

gain. It seems like you can gain certain things in
 

one direction and lose others, so can anybody speak
 

to that?
 

MR. ELLIOTT: Well, I'll attempt, and
 

certainly let Pete speak his mind on this too. I
 

think if the approach was to use the Department of
 

Labor's process, then the gain would be to NIOSH; we
 

would find ourselves somewhat distanced from -- from
 

this whole process. Certainly the perception of
 

conflict of interest exists for both agencies
 

because of our involvement in this program. And
 

that burden will just be shifted from NIOSH's -­

from our agency to theirs. And Shelby Hallmark,
 

Pete's boss, knows this and we've talked about this,
 

so I don't know that it gains much, if at all,
 

whoever has this, either DOL or NIOSH, we will be
 

walking a tightrope and we will be doing the best
 

that we can to manage and control perceptions of
 

conflict and avoid any actual conflicts.
 
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159 

MR. TURCIC: I agree with the points Larry
 

made. One aspect of it would -- from DOL's
 

standpoint would be that -- in the way the process
 

works is that if an individual, they have, you know,
 

once -- once a recommended decision is made, then
 

the claimant can raise issues during the final
 

decision point, and then from there they can appeal
 

that to the District Court. So, from, you know,
 

from that standpoint it would just be which part of
 

the, you know, process and where the individual
 

claimant would have recourse.
 

DR. ZIEMER: Let's ask others. Jim has a
 

comment.
 

DR. MELIUS: Yeah. First of all, I'd like
 

to thank Larry and Pete for, no matter what we
 

decide or recommend here today, for making the
 

effort to sort of develop an alternative because I
 

think it's good for the credibility of the process
 

that we did consider an alternative to NIOSH doing
 

this procurement should NIOSH go ahead and the, you
 

know, reasonable alternative was, you know, a
 

practicable one was looked into. I personally have
 

trouble weighing the benefits versus the possible
 

risks of problems with moving it to DOL without sort
 

of thinking through the whole process, and I think
 
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there are different points at which conflict can
 

arise or perceptions of conflict. There's also
 

different points at which, you know, scenarios where
 

certain problems may arise and, you know, which
 

agency is better or worse. And some of these -- as
 

with the conflict of interest, some of these
 

scenarios are unlikely to occur, but what if things
 

aren't going -- going well and at least to me, in
 

order to evaluate this, I'd like to sort of know
 

more details about the -- how the process should be
 

working, or how we plan the process to work for
 

actually get out these task orders and conducting
 

this review. And then think -- then almost work
 

back, which then, you know, how much do we gain from
 

the Department of -- of moving this to the
 

Department of Labor and how much would we lose from
 

the Department of Labor, you know, at least
 

potentially. And it's all going to be, I guess -- I
 

think, you know, realistically either agency could
 

do it fine. I mean that's -- and it's not a clear-


cut gain in perception either from either agency as
 

both Larry and -- and Pete have pointed out, but -­

but I think the details are what are going to be to
 

some extent important and the procedures we set in
 

place. As I said, I'd almost rather work from -­
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let's work through the procedures; how are we going
 

to the procurement and so forth; then go back and
 

say can both agencies deal with this. And then -­

then questions about which would be better, what
 

would be the delays involved in doing an MOU. We
 

don't have a great example up there historically to
 

work off of right now. And I want to go back
 

through my transcripts and count the number of times
 

Larry has said soon, or the next meeting. But -­

but I mean I -- we do have to look at that
 

realistically, but it is the procedures that maybe
 

work -- I would prefer that we work on them and then
 

go back to this issue.
 

DR. ZIEMER: A good point, Jim. And there's
 

no reason we have to, for example, decide at the
 

front end, but we have to at least know that's a
 

decision that's part of the overall picture as we
 

proceed here today and tomorrow.
 

Roy, a comment.
 

MR. DeHART: Thank you. Clearly, NIOSH has
 

played a role in helping us prepare this document as
 

a procurement document to meet the Federal
 

Regulations, etcetera. I would ask the Department
 

of Labor who has reviewed or who all have reviewed
 

this document, so that they're comfortable with it
 
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as -- as it currently is developed?
 

MR. TURCIC: The Division of Energy and
 

Employees Compensation, we've been -- we've reviewed
 

it and looked at it. And, you know, Jim made a good
 

point about the, you know, the process -- you know,
 

we have ideas of how, if it was administered by
 

Labor, how we would do that, and maybe what we need
 

to do is add some, you know, details to that.
 

DR. ZIEMER: But I think your question is: 


Is this in a form that looks like they could handle
 

it readily without major -­

MR. DeHART: And are the procedures in place
 

to do that, and I think we're being told that there
 

are planned procedures.
 

MR. TURCIC: Yeah, the procurement
 

procedures are all in place in order to do that. 


Either NIOSH or DOL could pick up what has been done
 

and affect a procurement, you know, that's -- those
 

are government regulations imposed to, you know, HHS
 

or DOL, so yeah, those are in place and can be done
 

readily.
 

DR. ZIEMER: Jim.
 

DR. MELIUS: Just to clarify or reiterate on
 

Roy's comment. I think what's important, this
 

review is the Board's -- it's our function, we're
 
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mandated to do this under The Act, and so the
 

process should serve our functions, what we need to
 

carry -- carry this out, and I think by -- we start
 

with what do we need to feel comfortable and have a
 

robust and solid scientifically based review
 

process. Then the questions will come up, you know,
 

I mean clearly just as Roy's question if DOL said
 

no, we'd have to start all over. Well, there's a
 

time issue or something. So I think it's
 

appropriate as we go along to ask whether or not
 

there would be a problem shifting to DOL. There's a
 

number of issues we really haven't, at least the
 

working group may have talked about with Larry and
 

his staff, but the whole Board hasn't, and I have
 

questions about a number of issues and procedures
 

that -- that I think are critical in terms of the
 

Board's carrying out its mandate that we need to
 

work through also.
 

DR. ZIEMER: Other comments, on this point
 

at least, on the issue of procurement? 


(No response.)
 

DR. ZIEMER: Okay. If not, can we agree
 

that we'll proceed with the related issues and then
 

we'll have to return to this at some appropriate
 

point.
 
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164 

I want to give Mark an opportunity, if you
 

have any comments to add on the procurement
 

documents, the final versions, anything you need to
 

point out to us or highlight, Mark?
 

MR. GRIFFON: I don't -- I don't -- I guess
 

on the procurement documents, I don't think I have
 

anything to add at this point. I think the second
 

set of overheads are -- after those three documents
 

is a set of overheads from one of the earlier
 

workgroup presentations, and that sort of goes
 

through some of the other issues regarding procedure
 

I think came up in our discussions, such as
 

selection and sort of a process of how the Board is
 

going to be now faced with a contractor and with
 

NIOSH, so I don't know if people have had a chance
 

to look at that, but they may be more relevant to
 

the discussion that we went through.
 

DR. ZIEMER: Then, what we're faced with
 

then is the issue of, in a sense, mapping out the
 

process for how the Board will review dose
 

reconstructions; how the work will flow; do we need
 

a subcommittee, a permanent subcommittee that will,
 

for example, decide on the cases that -- that will
 

be reviewed; what -- what will the product of those
 

reviews be, those kinds of questions, so there's a
 
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whole series of things beyond the procurement that
 

we need to consider. The ideal thing would be that
 

once the procurement is issued and a contractor is
 

selected, that we're ready to go knowing what we
 

will do, how we're structured to do it, and then we
 

simply move from there. And it may be that we won't
 

be able to close all the issues today and tomorrow,
 

but at least we want to identify what they are. 


I -- I guess I'd be willing to have people
 

raise the issues now. I see Jim's already raring to
 

go, and Wanda is getting ready to go. Jim, go
 

ahead.
 

DR. MELIUS: No, no, actually no. Wanda had
 

hers up.
 

DR. ZIEMER: Wanda, do you want to go? 


Okay. 


MS. MUNN: I just had a question based on
 

your comments. Has -- have we then decided that we
 

are going to use a subcommittee rather than a
 

working group to do this? Has that decision been
 

made?
 

DR. ZIEMER: Let me answer it in the
 

following way. The difference in definition between
 

a Working Group and a Subcommittee has to do with
 

tasks and longevity. The Subcommittee has an
 
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ongoing task and has a different set of rules by -­

by which it operates, as compared to a Working
 

Group, which is pretty much Ad Hoc; it has a given
 

task, it's a pretty much short term, and it's over
 

with. So one of the decisions -- or one of the
 

issues the Board will have to decide is do we wish
 

to have a Subcommittee to kind of oversee this task
 

of dose reconstruction reviews because it's clearly
 

an ongoing task and -- and we would be subject to -­

in fact, I think we have in the -- the -- we have
 

the Federal definitions of a -­

MS. MUNN: Yes, we do.
 

DR. ZIEMER: -- Subcommittee and the Federal
 

Register requirements for that are in the packet
 

here to recognize the implications of that, and -­

MS. MUNN: That was my concern.
 

DR. ZIEMER: -- we need to be careful that
 

we don't try to avoid that by saying well, we're
 

just going to have a -­

MS. MUNN: No. 


DR. ZIEMER: -- series of Ad Hoc Committees,
 

that's not going to -­

MS. MUNN: No, that won't do.
 

DR. ZIEMER: -- do it.
 

MS. MUNN: No. 

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DR. ZIEMER: So it appears to me, at the
 

moment, that this is an ongoing task and either the
 

Board does it as a Committee as a whole, or we say
 

that we need a Subcommittee, or perhaps more than
 

one. But -- but we have not made a final decision
 

on that, but I think it appears right now that there
 

may be -- need to be some subset of this Board that
 

has that as a responsibility.
 

Does anyone want to speak to the issue of
 

requirements?
 

MR. ELLIOTT: I just wonder if it wouldn't
 

be beneficial if Cori spoke to the differences
 

between a Working Group and a Subcommittee. The
 

Subcommittee -- and she can explain this better than
 

I -- but, you know, a Subcommittee operates as, in a
 

public way; a Working Group doesn't have to. If you
 

have a Working Group, it has a life to itself that
 

once its mission is done, like this Working Group is
 

charged to find the options available to you to do
 

your review, and you're done. So now -- and that's
 

a finite, discrete task. A Subcommittee has a more
 

long-term involved Charter of Mission that's it been
 

given, so.
 

MS. HOMER: A Subcommittee must be federally
 

established, or formally established as well, which
 
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168 

I think there's some examples of how that might be
 

done. I believe the Board probably has a different
 

idea in mind of what their Subcommittees would be
 

formed as, or like, and because your tasks are
 

different, then a conventional Subcommittee would
 

be. But the general rules apply: the openness,
 

announcement in Federal Registers; availability to
 

public and anybody who wants to attend, either via
 

conference call, or in an open meeting. All of the
 

rules that apply to a full Board meeting apply to
 

Subcommittee meetings. Again, as Workgroups go,
 

very, very finite specific tasks, and then the
 

Workgroup is done, so.
 

DR. ZIEMER: Thank you, Cori. Now, keep in
 

mind that the Subcommittee is not necessarily doing
 

the reviews of individual dose reconstructions, they
 

are probably overseeing the flow of work, deciding
 

what percent or what numbers of different categories
 

of dose reconstructions will be reviewed, perhaps
 

assigning the tasks of the review process to Board
 

members and consultants, that kind of thing. As I
 

would see it, they're not actually the group that's
 

necessarily sitting there reviewing particular
 

projects, or dose reconstruction. Is that how you
 

saw it, Mark?
 
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169 

MR. GRIFFON: Yeah, that's similar to the
 

way we outlined it in some of our, you know, in some
 

of our earlier discussions, I mean we talked about
 

having a Subcommittee to do selection, and selection
 

of not only of individual dose reconstructions, but
 

site profiles to review, and things like that. And
 

then to have sort of rotating Board members working
 

with the contractor or contractors that are doing
 

dose reconstruction, so that we would sort of split
 

the share of the work on the actual reviews, so
 

that's certainly the way we constructed it, yeah.
 

MR. ELLIOTT: If I could add to that, kind
 

of the way I had envisioned what you've been talking
 

about in the Working Group -­

WRITER/EDITOR: You're mike's not working. 


I'm sorry.
 

MR. ELLIOTT: Now I'm on?
 

WRITER/EDITOR: Yes.
 

MR. ELLIOTT: Okay. It's magic. You could
 

have a panel of Board members working with your
 

contractor as Working Groups, you know, the finite
 

task there is work with the contractor, come up with
 

a review of a sample of dose reconstructions that
 

you have been given as a panel. The Subcommittee
 

itself could identify what dose reconstructions of a
 
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representative sample would be reviewed, and how
 

those are brought to the Board; so you could
 

reconvene your panels as you need them -- or Working
 

Groups as you need them. That's one scenario as how
 

it might work. 


DR. ZIEMER: Any other general comments? 


Jim, did you have one?
 

DR. MELIUS: I don't know quite where we're
 

going, if we're going to discuss this
 

Subcommittee/Workgroup issue more, or do we need to
 

defer that for a while, or?
 

DR. ZIEMER: I think, again, we're trying to
 

get the issues on the floor -­

DR. MELIUS: Yeah.
 

DR. ZIEMER: -- because none of them are
 

sort of made in isolation, and it may be helpful to
 

identify what -- what particular things have to be
 

done, and then try to put them together.
 

Do you have another comment?
 

MR. ESPINOSA: We're a small group -- we're
 

a small group as it is. Does a Subcommittee have to
 

be a majority of the members?
 

DR. ZIEMER: No. 


MS. ESPINOSA: Okay. 


DR. ZIEMER: No. I don't recall that there
 
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171 

are actually any size specificity to it.
 

MS. HOMER: There are no specific, no, you
 

can have it as two people if necessary.
 

MR. ESPINOSA: I was looking through it and
 

I couldn't find that there.
 

DR. MELIUS: And it can include 


outside members?
 

DR. ZIEMER: I believe you can have outside
 

consultants.
 

MS. HOMER: Consultants, not members.
 

DR. MELIUS: Yeah, consultants, excuse me,
 

not members.
 

DR. ZIEMER: Roy?
 

MR. DeHART: I'm not trying to avoid the
 

formality of the Subcommittee, but I see it being
 

stifling in terms of flexibility and ability to move
 

quickly and be able to handle a lot of work. I
 

would think that we could do that in Working Groups,
 

still keeping the tasks very limited, very specific,
 

and move from one Working Group to another Working
 

Group, to another Working Group, different people,
 

and avoid the formality of a Subcommittee, and
 

that's what I'm going to be trying to think about as
 

we're going through.
 

DR. ZIEMER: Yeah. You may be suggesting a
 
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172 

scenario where the Board acts as the Committee as a
 

whole to determine the nature of the work. The part
 

that you just described sounds like the second part
 

of what Larry was talking about; these are the
 

subsets which work on -- it's like a Working Group
 

that has a task of reviewing this dose
 

reconstruction and then they're done, as opposed to
 

the coordinating function of deciding which sets of
 

-- of dose reconstructions are to be reviewed and
 

that sort of thing.
 

DR. MELIUS: Not disagreeing with that
 

sentiment, trying to avoid, you know, additional or
 

formal meetings and so forth, but I think one of the
 

criteria we need to think about with that is, is the
 

function so unwieldy or practical to do as a full
 

Board meeting, or that the waiting for full Board
 

meetings could delay that; but at the same time is a
 

function that there should be some transparency to,
 

that the public should have the opportunity to
 

comment and be aware of what was happening with the
 

Committee, there would be formal minutes and so
 

forth of that. So there may be functions that are
 

in between what a Workgroup should do -- could do
 

and there are -- I guess the third levels that are
 

sort of Workgroup reviewing it, you know, individual
 
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case or something and going through all the
 

documents is not something that can necessarily be
 

done easily and in public, or should even be done in
 

public. But I think we have to be a little bit
 

careful about sort of setting up a series of Ad Hoc
 

Workgroups that sort of hide this from the public as
 

a way around that process. And that there could be
 

something in between also that where a -- for
 

example, a Subcommittee that would meet regularly by
 

conference call once a month to do this function may
 

be a way, you know, it could be announced in the
 

Federal Register, people could participate maybe one
 

way in between of dealing with certain -- certain
 

selected issues, selecting the, you know, the nature
 

of the cases to review, the process or whatever, to
 

do that. At the same time it's a little harder to
 

see where making assignments and so forth will be
 

easily done that -- that way either, and where that
 

would fit. But maybe if we work through what
 

exactly we would -- what the steps would be, that -­

that we could then decide. But I do think we have
 

to keep in mind that it is a -- there should be some
 

-- the more transparency there is to this process,
 

the more credibility it will have.
 

MR. GRIFFON: Just one -- one more -- what
 
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174 

did he say, ad nauseam we comment. Anyway, just I
 

mean one more question on the Subcommittee. As I
 

understand the -- the -- looked into the FACA Rules
 

a little bit, and it says that if there's no further
 

deliberations on the Advisory Committee, then the
 

Subcommittees have to adhere to the public -- public
 

functions, that they have to be held publicly, but
 

if they -- if you read that backwards, then if they,
 

you know, the Subcommittee can act more like a
 

Working Group where we select cases, select the -­

make the criteria, select cases, and bring them to
 

the full Board, and the Board deliberates over it
 

and agrees and puts that forward, I don't think, in
 

that case, it's really a Subcommittee that has to
 

adhere to the public requirements.
 

DR. ZIEMER: Well, we need some expert
 

opinion on that.
 

MS. HOMER: I would like to point out, which
 

I probably didn't make clear before, whether or not
 

it's a Workgroup or a Subcommittee, the decisions or
 

work done by Subcommittees or Workgroup has to be
 

brought to the full approval of the Board.
 

DR. ZIEMER: Well, yes, and the Workgroup in
 

-- in fact, brings its findings to the Board and at
 

which point they become public. It was just the
 
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175 

issue there that they can deliberate privately while
 

developing the work product that they bring to the
 

Board. In the case of the Subcommittee, that -­

closed deliberations are also done in an open forum.
 

MR. GRIFFON: And the only reason I raised
 

that is not that I don't want it to be open, but
 

that the flexibility question that Roy raised, you
 

know, might be easier to conduct without that.
 

DR. ZIEMER: Now, this again is not an issue
 

we have to decide at the front end because it may be
 

driven more by what the process itself looks like,
 

how we're going to do the review. For example, we
 

may need to begin looking at how it is we're going
 

to conduct these reviews; what is it going to look
 

like in terms of consultants and Board members; are
 

we going to have a series of small panels or what. 


And maybe we need to think about working from that
 

end and working back to see what the total picture
 

would look like. Are we going to have a number of
 

these subset groups working with the consultants, or
 

-- or having consultants do the work and then
 

meeting with them, or that kind of thing. We
 

haven't really decided how that's going to happen,
 

right? And then decide what that's going to mean in
 

terms of participation by this Board for example, is
 
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176 

everybody on the Board going to be involved in that,
 

or just certain ones. Again, that's -- the Board
 

can decide to do this anyway it wishes, I think at
 

this point. We're not bound by any particular
 

requirement. 


So I'm going to suggest, and this may be a
 

good time to take a break because you may need to
 

collect your thoughts on that, but to determine what
 

the reviews are going to look like and what the
 

product of those reviews will be, and then back that
 

up. We have an idea, and I think we have an idea of
 

the numbers of reviews, we've talked about
 

percentages and so on. 


Just before the break I want to remind
 

members of the general public if you do wish to
 

speak at the public comment period, please be sure
 

to sign up. 


We'll take a 15-minute recess.
 

(Whereupon, a recess was taken.)
 

BY DR. ZIEMER: (Resuming)
 

Now, before we go further in discussing some
 

of the issues in the review process and so on, we
 

have an opportunity to learn a little more about the
 

Task Order Contract Award Processing and the length
 

of times involved. And Martha will walk us through
 
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177 

that. There is a handout that should be at your
 

place. It's a blue background that says Task Order
 

Contract Award Processing.
 

Martha, are you set to go on this?
 

MS. DiMUZIO: Yes. Larry asked that I just
 

provide you all with some information about how
 

exactly the task order process will work, so
 

obviously this is all after award of the contract. 


But just to give everyone a little bit of
 

information about the timing on the contract, once
 

we're ready -- once we're -- well, at least for the
 

NIOSH process, obviously it needs to be determined
 

whether NIOSH or DOL is going to handle the
 

contract, but if it were to go through the NIOSH
 

process we would need to send it -- we're ready to
 

go basically now. The documents that -- it would
 

need to go to Atlanta for approval, that usually
 

takes again, about a week for processing, but for
 

actual, formal solicitation and everything, it has
 

to be out on the street for a minimum of 30 days and
 

it can be as much as 45, but we would be requesting
 

30 days with proposers given a minimum of 30 days to
 

respond. So then you would have the technical
 

evaluation panel meet and evaluate those proposals
 

and that's not really on this slide here
 
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178 

(indicating), I apologize. I thought I should -­

this is sort of after award which is up on the
 

screen, but I realize no one knew the timing for
 

actually award of the contract, so after, you know,
 

the technical evaluation panel meets and so forth,
 

it could be, you know, a hundred and -- a minimum of
 

120 days from the time that NIOSH submits the
 

contract to the Procurement Office before an actual
 

award is made. So just some initial information
 

about the actual award of the contract and the
 

timing on that. 


But what we have here is the contract has
 

already been awarded and we're ready to start
 

submitting task orders to the contract, so the
 

Advisory Board meets either as a Working Group or a
 

Subcommittee, develops the task order request, along
 

with the Independent Government Estimate and submits
 

it to NIOSH. So it will come to OCAS in Cincinnati,
 

and we'll prepare the necessary funding information,
 

and then that needs to be forwarded to Atlanta for
 

approval by both the NIOSH/AD Office and the CDC
 

Financial Management Office. And historically, that
 

takes approximately two weeks. Then -- then Atlanta
 

will forward the information on to the Procurement
 

Office, who will prepare the task order and submit
 
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it to the contractor proposal; again, about a week.
 

The contractor will prepare the response to the
 

Board's proposal, and according to the contract,
 

they have up to 14 days to submit their proposal. 


That's then -- we receive the proposal back, that is
 

then reviewed by the Advisory Board; if they accept
 

it, it can be awarded; and I will say approximately
 

another week. If the Board requests revisions to
 

that proposal, the contractor has an additional week
 

to respond to any revisions. So basically what will
 

happen is, you know, on average, once the Board
 

submits a task to NIOSH, it will take approximately
 

seven to eight weeks for that task to be assigned to
 

the contractor to start work.
 

DR. ZIEMER: Okay. Everybody understands
 

this is after the procurement?
 

MS. DiMUZIO: This here is after the
 

procurement.
 

DR. ZIEMER: This is two months, sort of
 

minimum, if a procurement is completed and we have a
 

contract.
 

MS. DiMUZIO: Right.
 

DR. ZIEMER: Now, remind us again how long
 

under optimal conditions will the main procurement
 

take? I don't know -­
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MS. DiMUZIO: Under optimal conditions -­

DR. ZIEMER: Optimal conditions.
 

MS. DiMUZIO: Under optimal conditions the
 

proposal would be out on the street in the Commerce
 

Business Daily for 30 days -­

DR. ZIEMER: Right.
 

MS. DiMUZIO: -- so the bidders would have
 

30 days to respond -- it would be out as an
 

announcement for 30 days, and then during that time
 

frame they have the -- the bidders will propose
 

their thing; then the Technical Evaluation Panel is
 

established, and they review the proposals that have
 

been submitted. That -- depending on the quality of
 

the proposals that are submitted, and if you need to
 

go back and forth and do best and final and so
 

forth, that could be an additional two to three
 

months, depending on the number of bids and so
 

forth. And then after the Advisory -- after the
 

Technical Evaluation Panel has selected the -- the
 

best proposal, from there it usually takes about
 

another two to three weeks for the actual award.
 

DR. ZIEMER: So it would appear that
 

somewhere in the range of three to four months are
 

required to bring the procurement to closure, and a
 

couple of more months to get the first task order in
 
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place. So I'm just trying to make sure the Board
 

has a feel for timing here, that you're ready to go
 

on the first task order, if you started today with
 

the procurement, that it would be somewhere
 

approaching six months from now before you're ready
 

to go with the first task order. Is that -- am I
 

correct on that?
 

MS. DiMUZIO: Yes.
 

DR. ZIEMER: It might be slightly better
 

than that?
 

MS. DiMUZIO: It could be slightly better,
 

but -­

DR. ZIEMER: But not -- not very much
 

better, and it could be a whole lot worse.
 

Jim?
 

DR. MELIUS: Yeah. I have a question. This
 

is related to that Working Group/Subcommittee issue,
 

and it's really the first bullet up there. The
 

Advisory Board would submit a task order request,
 

along with the Independent Government Estimate. 


That's a new Independent Government Estimate, which
 

means that that has to have -- well, that whole
 

procedure really requires a meeting in person, and
 

then a closed session, and you know, announcements
 

and so forth, and I mean I think we have to factor
 
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that into this decision on how to -- how to operate
 

it. And so much of that depends on what the detail
 

is of the task order; do we want to do a detailed -­

I mean there's lots of ways we could do it, but -­

but we do the elements of the task order through a
 

Working Group or something, then the Independent
 

Government Estimate is part of an actual Committee
 

meeting. But if we're going to be doing a lot of
 

task orders between meetings, it depends on the
 

frequency of the task orders, then I almost would
 

argue for a Subcommittee, which would allow you -­

which would have to meet in person, but would be
 

allowed to do the Independent Government Estimate. 


Is that -- that's my question.
 

DR. ZIEMER: Martha, you were going to talk
 

to us a little bit, were you, about that Independent
 

Estimate right now?
 

MS. DiMUZIO: Yes. I did just -­

DR. ZIEMER: Give an example?
 

MS. DiMUZIO: But -- but Dr. Melius is
 

correct, you would have to have some type of an
 

Executive Session in order to develop that
 

Government Estimate, whether it's a Subcommittee, or
 

the full Board, or whatever, so -­

DR. MELIUS: But -- but it can be done by a
 
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Subcommittee?
 

MS. DiMUZIO: It could be done by a
 

Subcommittee because the Subcommittee can act on
 

behalf of the Board, correct, Cori?
 

MS. HOMER: They cannot act on behalf of the
 

Board. Everything that is discussed has to be
 

decided by the full Board, not the Subcommittee.
 

MS. DiMUZIO: Okay.
 

DR. MELIUS: That's what I -- that's what I
 

want to make sure of.
 

MS. DiMUZIO: So basically it would be
 

Independent Government Estimate associated with an
 

individual task. What I did for, just for the sake
 

of this meeting, is I just took the sample task,
 

Attachment D, from the -- from the current proposal
 

that we have and developed an Independent Government
 

Estimate, you know, and -­

DR. ZIEMER: This is a sample only.
 

MS. DiMUZIO: Yeah, obviously it's a sample
 

only because I'm sure a Health Physicist -­

DR. ZIEMER: Nobody should take the $2 an
 

hour rate for a Health Physicist very seriously.
 

MS. DiMUZIO: That's right. So we just
 

wanted the Board to see what type of information
 

that needed to be included in -- in the Estimate as
 
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it goes forward, so this is, you know, this is the
 

type of information that would be required, so -­

I'm sorry we don't have this on a slide -- but you
 

would -- initially you would have -- the staff would
 

be identified, and normally when you -- once the
 

contract is awarded, the staff is usually
 

identified, so you -- you may possibly be listing
 

staff here by name. And then, obviously you would
 

know what their hourly rates are and so forth; so,
 

you know, you would total their salaries and their
 

benefits to come up with the personnel costs; if
 

travel is necessary, you know, we would add in those
 

costs, you know, as required; any miscellaneous, you
 

know, and that's postage, mailings, you know,
 

anything like that; then the overhead costs that the
 

contractor is charging, a subtotal, and then any
 

fee, award fee, that the contractor is entitled to,
 

to come up with the Independent Estimate and which
 

would then be submitted to the -- along with the
 

task order, to the Procurement Office for
 

processing. 


MR. ELLIOTT: Martha, I think I'm correct in
 

this, but help me out. There would be a need to
 

have two executive sessions on any individual task
 

order, would there not? One to prepare in advance
 
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the task order and the Independent Government Cost
 

Estimate to be submitted to the contractor, then
 

once you get the proposal back on that task from the
 

contractor, it would require another Executive
 

Session of whoever, the Subcommittee or the Board,
 

to examine that proposal, deliberate upon the
 

Independent Cost Estimate -- or the proposal cost
 

estimate -­

MS. DiMUZIO: Cost proposal versus -­

MR. ELLIOTT: -- matching against
 

Independent -­

MS. DiMUZIO: -- Independent Government.
 

MR. ELLIOTT: -- and provide any negotiation
 

points back to the contracting officer.
 

MR. DiMUZIO: I would -- I would give a
 

qualified yes to that, only from the standpoint that
 

it's possible that once you've received a proposal
 

back from the contractor, you could say in a meeting
 

that the -- the estimate was -- if you don't have a
 

problem with the estimate, I don't believe you would
 

need to go into Executive Session -­

MR. ELLIOTT: Okay. 


MS. DiMUZIO: -- to discuss the estimate.
 

MR. ELLIOTT: So the Board -- the Board or
 

the Subcommittee of the Board could -- could specify
 
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to the contracting officer that if the proposer's
 

cost proposal is within or lower than the
 

Independent Cost Estimate -­

MS. DiMUZIO: Yeah, so -­

MR. ELLIOTT: -- they don't have to have
 

that yet.
 

MS. DiMUZIO: Right, so at a meeting of the
 

full Board you could just say we -- you know, we
 

accept the proposal, the cost proposal as submitted
 

by the contractor, and you wouldn't have to go into
 

what the Independent Government Estimate was.
 

DR. MELIUS: The second -- the potential
 

second Executive Session, does that have to be the
 

full Board or can it be a Subcommittee of the Board?
 

DR. ZIEMER: I think that's the same
 

question, is it not, Cori?
 

MS. HOMER: Yes.
 

DR. ZIEMER: Decisions must be made -­

MS. HOMER: Anything can be discussed by a
 

Subcommittee as a full committee, or as you can a
 

full committee, but anything that a Subcommittee
 

does has to brought to the full Board for discussion
 

and determination.
 

DR. MELIUS: So that would -- that means
 

this process then, you just, the Board, we meet once
 
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every six weeks, you're talking about a six week -­

MS. MUNN: Hiatus.
 

DR. MELIUS: -- another you can add to this
 

task order processing, what, at least another four
 

weeks, I think, but, you know, on average if it has
 

to be the whole Committee.
 

MS. DiMUZIO: Could you do that as a
 

conference call?
 

DR. MELIUS: If it doesn't involve an
 

Independent Government Estimate.
 

DR. ZIEMER: I think we already determined
 

that a conference call for an Executive Session
 

probably doesn't work, right?
 

MS. HOMER: It must be a secured call.
 

MR. ELLIOTT: It wouldn't -- a conference
 

call wouldn't work if you had to have an Executive
 

Session, but if you got around that, you didn't have
 

to have an Executive Session to discuss independent
 

-- discuss the proposer's cost estimate you could do
 

everything you need to do by -- by teleconference.
 

DR. MELIUS: But you wouldn't necessarily
 

know that until it was submitted.
 

MR. ELLIOTT: That's right.
 

MS. DiMUZIO: But I mean particularly in the
 

beginning when the contract is first awarded, I mean
 
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if it's possible that we have a series of task
 

orders ready for when the contract is awarded, I
 

mean you could have sort of one session where you
 

reviewed several tasks at least to get the process
 

started.
 

DR. MELIUS: I -- I think that makes -­

obviously makes sense, but I'm just trying to figure
 

out the alternative, and whether there is any other
 

way of -- on that.
 

DR. ZIEMER: Which perhaps emphasizes the
 

need to have some tasks ready to go at the front end
 

of the process then.
 

DR. MELIUS: We'll have to agree to accept
 

this rate of $2 an hour for a Health Physicist.
 

DR. ZIEMER: Okay. Any other questions for
 

Martha on this issue? 


Okay. Thank you, Martha, that helps frame
 

out the time constraints or lack thereof that we
 

have with this process.
 

DR. ZIEMER: Cori, do you have a comment?
 

MS. HOMER: Conference calls for closed
 

sessions have been conducted by CDC conference call
 

bridge, and that is considered secure. We'd have to
 

double check and have absolute certainty, but I know
 

that it has been done in the past and if others have
 
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considered it secure, then it may be secure enough
 

for our purposes as well.
 

DR. ZIEMER: Okay. Thank you.
 

Now, let's -- let's focus back now on the
 

tasks before us. I'm -- I'm trying to develop a
 

feel for how to go about this, and I'm not smart
 

enough to have figured it out yet. It seemed to me
 

that it might be helpful to look at the -- I'm
 

trying to see which document it is -- the Statement
 

of Work and the various types of reviews we have to
 

do, or that we say that we would like to do, and try
 

to get some ideas on the floor as to how we would
 

carry those out as far as this Board. 


MR. GRIFFON: Attachment C.
 

DR. ZIEMER: Attachment C, right. 


Attachment C of Draft 1/31/03, Request for Contract,
 

and beginning on page 15 we have the Individual Dose
 

Reconstruction Review; and then we have the Advanced
 

Review; we have the Blind Dose Reconstructions; then
 

we have the section on Site Profiles and so on. 


It seemed to me sort of intuitively that if
 

we could begin to address these maybe section by
 

section, Individual Dose Reconstruction Review,
 

let's take that as the simplest case. How are these
 

to be carried out? That's not simply a rhetorical
 
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question. I mean it is rhetorical at this point,
 

but I think we now need to come to grips with that. 


And I -- I think it might be helpful, and I'm going
 

to -- Mark, I'm going to put you on the spot and say
 

okay, the Working Group sort of had a model in mind,
 

and if you can remind us of that, and then let's
 

take off from there and flesh it out a bit.
 

Well, the Chair always has the prerogative
 

of getting other people to come up with the good
 

ideas, right?
 

MR. GRIFFON: Yeah, I'm not sure. I think,
 

Paul, what you're asking for is -- is assuming that
 

we've selected the cases already, or do you want to
 

back up and go into how we're selecting the cases?
 

DR. ZIEMER: I think we have to -- have to
 

talk about that as well.
 

MR. GRIFFON: Okay. Okay. I mean -­

DR. ZIEMER: In order to define the scope of
 

what it is this Board is going to be doing because
 

we're going to have to have task orders for all of
 

this. Unless we can put it -- unless we can -­

MR. GRIFFON: Right.
 

DR. ZIEMER: -- delineate it we can't write
 

a task order.
 

MR. GRIFFON: Yeah, I think one clear place
 
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we have to start is the selection process, and I
 

think it might be -- we threw out some parameters in
 

past discussions on how we would look at selection. 


We know a percentage of cases that we're going to
 

consider. I think we also have to look at case
 

availability, so this is hard to do without looking
 

at the actual data base to know, you know, what
 

cases are available for us to review -- you know, if
 

you have a certain selection criteria, but there's
 

no cases that fit into that realm in the first round
 

of cases that are done by the contractor, then we're
 

kind of sitting -­

DR. ZIEMER: But see, you've defined the
 

first step. Somebody is going to have to review the
 

available cases, I mean maybe that's step one,
 

right? And then we would say, and who is going to
 

do that, is that the full Board or is that a subset.
 

DR. ANDRADE: Paul -­

DR. ZIEMER: That's what I'm -- I'm trying
 

to call out these issues. Okay. 


DR. ANDRADE: I think this is a critical
 

point for everybody to keep in mind as we go through
 

this discussion, and that is that we have to all be
 

clear, and be on the same page of music, by the way,
 

on whether -- what you mean by availability are
 
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cases that have been at least taken to the level of
 

being sent back after the -- after the final dose
 

reconstruction. Okay. Realize that all the
 

language that's written here in the Statement of
 

Work is in the past tense, and I think, in my own
 

opinion, it was perhaps fortuitous that it was done
 

this way, perhaps we just got lucky, that if -- if
 

we recall and remind ourselves that it is done in
 

the past tense, and we really will be developing a
 

quality review process, we're going to be second
 

guessing the dose assessors as they're doing the
 

work then I think we will then be overstepping the
 

boundaries or the intent.
 

DR. ZIEMER: I -- I believe, and others can
 

correct me, it was certainly my understanding that
 

this is an audit that's after the fact.
 

DR. ANDRADE: Okay. 


DR. ZIEMER: It's completed dose
 

reconstructions. Is that not everybody's
 

understanding?
 

DR. MELIUS: Yeah.
 

DR. ANDRADE: Okay. Very good. I think
 

that -- that helps. 


DR. MELIUS: But I'm just saying, agreeing 


-- fully agreeing with that, but I think for the
 
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purposes of this task or this selection we're going
 

to have to be projecting out because of the time -­

because of where we are now in the process because
 

of the time frame going out, we're going to have to
 

be able to project out numbers. We're not going to
 

be actually doing selection, but -­

DR. ZIEMER: But knowing what cases are
 

coming down the line and some numbers of future
 

cases will be selected.
 

DR. ANDRADE: If that's what you mean by
 

availability then -­

DR. MELIUS: That's -- that's -- yeah.
 

MR. GRIFFON: Yes.
 

DR. ZIEMER: But it's completed cases that
 

are looked at.
 

DR. MELIUS: But -- but, and we are going to
 

have some estimate of availability, but then when
 

the actual selection takes place it will only be
 

from the completed cases -­

MS. MUNN: The available pool.
 

DR. MELIUS: -- the available pool, and do
 

that, and we're going to have to probably recognize
 

that our projections are not always going to be good
 

because, you know, things get delayed or whatever,
 

particularly as we get into some of the finer points
 
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of types of cases from different sites and things
 

like that, that's going to be maybe hard to fill. 


And we're going to have to have some flexibility in
 

how these cases are chosen -- will be chosen at the
 

time for review.
 

DR. ANDRADE: Absolutely. I think then
 

almost by default we have solved, or probably come
 

to a conclusion here about one of the bigger
 

problems that was laid out even earlier, and that is
 

the issue of conflict of interest between the
 

administrative handling of this process by NIOSH
 

and/or the Department of Labor. If this is -- is
 

this is to be done after the fact, then there is no
 

conflict of interest with the Department of Labor. 


DR. ZIEMER: Are you saying the case would
 

have already been adjudicated?
 

DR. ANDRADE: Absolutely.
 

DR. ZIEMER: Let me ask a question now,
 

Mark. When you said identify available cases, you
 

are suggesting these be identified generically by
 

type, location, or what? In other words, I'm asking
 

you is this something that could be done as you're
 

saying, in open session, we're not identifying
 

individuals; you may identify sites, types of cases,
 

numbers of cases, something that -­
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MR. GRIFFON: Yeah, I think -­

DR. ZIEMER: -- can be done by the full
 

Board -­

MR. GRIFFON: Right. I think -­

DR. ZIEMER: -- in open session that we say
 

okay, at this meeting we've set aside some time -- I
 

mean I could see at each Board meeting having some
 

time set aside where we do this.
 

MR. GRIFFON: Yeah, generally I think so. I
 

think we can discuss some, we've already discussed
 

some potential parameters, you know, but we -- we
 

didn't get more specific than that. I guess the
 

question I was running through my head was -- and it
 

depends on how we lay out this task order -- but if
 

you have a task order to be completed in one or two
 

years or whatever, you estimate a budget for the
 

first year, and based on our sampling scheme there's
 

no cases completed that meet those criteria, then
 

we, you know, we failed. So we've got to project
 

and that might have, you know, we'd have to work
 

with NIOSH to see, you know, maybe by -- by finding
 

out what they have in the hopper, what they're
 

working on, you know, the -- you know, just as an
 

example, if they were doing all Hanford cases first,
 

I know they're not, but if, you know, they were
 
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doing all Hanford first, then, you know, our
 

criteria is, you know, we're not meeting all our
 

sampling criteria, so just projecting like Jim said,
 

the numbers.
 

DR. MELIUS: My thinking, that would be a
 

task for a workgroup to do, and come back to the
 

Board with sort of the parameters of that, you know,
 

the task, based on where we see NIOSH is, and what
 

NIOSH is projecting, a number of other, some of
 

these (inaudible) -- there will be so many cases
 

available for, you know, completed cases available
 

within this time period for review. And that to me
 

would be something that could be probably better
 

done by a workgroup talking to NIOSH. Then maybe an
 

affirmation of that, or even the final selection be
 

done by the, or which could be done and I think sort
 

of very easily and naturally as part of this task
 

order development.
 

DR. ZIEMER: We're just getting ideas on the
 

floor now.
 

DR. MELIUS: Yeah, yeah.
 

DR. ZIEMER: We have not approved
 

workgroups.
 

Tony.
 

DR. ANDRADE: Okay. Then I have a question
 
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of Jim. Jim, to the best of your knowledge, in the
 

cases that have been reviewed, some preliminary dose
 

reconstruction done, or perhaps even finals, even
 

though you describe your work as having attacked
 

those cases that are quote, low-hanging fruit at
 

this particular point in time, do you believe that
 

you have a good representative sampling of a wide
 

variety of cases?
 

DR. NETON: With a sample size of 18, I'd
 

say no. Eighteen out of 10,000, so. But we do have
 

a couple of different approaches that one could look
 

at, but obviously there's -- there's a number of
 

things like AWE's and such that would not be
 

included.
 

DR. ZIEMER: Keeping in mind that this
 

process may be six months off before it gets
 

underway and looking what's in the pipeline, I think
 

the sense of the question is how representative and
 

what -- what we have now that's coming onscreen in
 

the next six to eight months, how representative is
 

that?
 

DR. NETON: I think -- I think Mark Griffon
 

hit it -- hit it on the head. The Board needs to
 

work with us and the ORAU contractor to determine
 

what the plan of attack is for the upcoming six
 
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months to a year, and then develop a sampling
 

schedule based on that. I'm not convinced with the
 

task order you really need to identify specific
 

types of review. I mean you're really just talking
 

about numbers of reviews period, and you don't
 

really need to get that specific I don't think.
 

MR. GRIFFON: Yeah, the only thing I was
 

thinking, Jim, is that if we do specify a number of
 

reviews and then given the criteria we've laid 


out --


DR. NETON: Yeah.
 

MR. GRIFFON: -- we're overwhelmed with one
 

type of case -­

DR. NETON: Right.
 

MR. GRIFFON: -- but we don't have any of
 

the others, then we, you know.
 

DR. NETON: But I think there were complete
 

-- wasn't it just like advanced versus basic. I
 

mean it didn't break it down into compensable versus
 

noncompensable.
 

MS. ROESSLER: No.
 

DR. NETON: So I think you could, you know,
 

the sampling strategy is you're going to take a
 

certain percentage of those and do an advance
 

review, so if we predict that there's going to be a
 
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thousand cases -­

MR. GRIFFON: But you're -- you're also
 

looking at the types of review versus the parameters
 

by which to select cases, and those are two
 

different things.
 

DR. NETON: Yeah, and I've forgotten what
 

those were.
 

MR. GRIFFON: I mean the -- the parameters
 

we were thinking about were -- were site,
 

complexity, the -- the -­

DR. NETON: And I think we're far enough
 

along where we could work with ORAU and develop a
 

sampling strategy for the -- the sites that may be
 

coming through, but based on the -- it's really now
 

being driven by the completion of the site profiles,
 

that's sort of the limiting factor at this point. 


Once you have a full set of data on someone and they
 

appear to be noncompensable, if you don't have the
 

complete site profile in place, it can't move
 

forward, so as those site profiles become completed
 

at least for certain blocks of years, we can give
 

you an indication of which cases will be moving
 

forward in fairly large chunks. 


DR. MELIUS: Two things; one is just a
 

follow-up to that. I think you said you were doing
 
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a first-come-first serve, you know, in the order
 

that they were received, so, you know, from taking
 

into account these other parameters like site and
 

profile, I think you could, with some time and
 

effort, sort of figure out how to do it. And I
 

think that would be a way, and then you're just
 

going to be estimating what's going to be a complete
 

case, available case at some point down the road or
 

within a certain time period. I also think, though,
 

we have to be careful that we may have a general
 

sort of task order in terms of -- it wouldn't
 

specify the cases, but we also have to work out a
 

procedure for how those actual cases will be
 

selected. I mean we don't want to put us in the
 

position of having -- or put NIOSH in the 


position -­

MR. ELLIOTT: We're not going to select
 

them.
 

DR. MELIUS: Yeah, you're not going to want
 

to be in the position of making the selections, so.
 

DR. NETON: If I could point out, just make
 

-- Martha can correct me if I'm wrong, but I think
 

if you write a task order for a certain volume of
 

work or it ends up being adopted, you can always
 

extend it. If you don't complete that work in that
 
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given contract year I think we have the option to
 

just say okay, we'll carry this over in subsequent
 

years.
 

MS. DiMUZIO: Right. What I was going to
 

say is that, you know, you can say that --


WRITER/EDITOR: You need to use the mike.
 

MS. DiMUZIO: The task order can say that
 

you're going to review the cases; you want the
 

contractor to review 70 cases over the year. That
 

doesn't mean you have to have those 70 cases
 

identified at the start of the task order. You
 

could, you know, you could look at the matrix or,
 

you know, give NIOSH some type of guidance on what
 

your matrix, you know, of what you'd like to look
 

at, and we can see how the matrix is and what type
 

of numbers that you're looking at. So you don't
 

really have to, when you assign the task order, at
 

that point in time, know exactly what the cases are. 


You know that you want the contractor to review 70;
 

you could give him 10 now, you know; 50 in three
 

months, you know, cause you're going to give them,
 

you know, however long; you want 70 cases in a year,
 

so you would probably do a task for one year for
 

those 70 cases. So you really don't have to know
 

upfront prior to award of that particular task
 
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exactly what those tasks are.
 

DR. NETON: We could always add or -­

MS. DiMUZIO: And we could always modify. 


Yes, we could add time to the task if we realized we
 

didn't get the right matrixes that we wanted or
 

reduce time and reduce the number, and then, you
 

know, reduce cost or something like that, so.
 

DR. ZIEMER: Just one second. I want to
 

capture a thought because I think, Jim, your comment
 

moved us to the next item after availability, but I
 

can't remember what you said.
 

DR. MELIUS: On the case selection.
 

DR. ZIEMER: Case selection.
 

DR. MELIUS: Yeah, and if I can -­

MR. PRESLEY: Go ahead because that was what
 

I was going to talk -­

DR. MELIUS: Well, my -- it was this
 

workgroup -- if we did this sort of workgroup, it
 

could also be not only work on the parameters of
 

this task order, but also a case selection, specific
 

case selection process; how are we going to select
 

cases and meet these parameters, and what's an easy
 

way of doing it without having to, you know, wait
 

until the cases are through the process.
 

MR. GRIFFON: Yeah, how -­
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DR. ZIEMER: Well, by case selection you're
 

identifying them by sort of generic features, not 


by -­

DR. MELIUS: And then we'd also -­

MR. GRIFFON: We're talking stratified
 

sampling, I guess, yeah.
 

DR. ZIEMER: Yes.
 

DR. MELIUS: Then how will the actual cases,
 

a process for how the actual cases will be selected
 

once they -­

DR. ZIEMER: Right. I'm just going to jot
 

down as another case selection process is the issue. 


Okay. Now, Robert.
 

MR. PRESLEY: Well, when we started the
 

working group we started talking about a percentage,
 

and then we went off and talked about looking at the
 

highest number of cases from a given area being the
 

highest that we would do, and then go back and look
 

at the AWE areas, maybe the AWE areas where we were
 

having the most trouble, and try to pull some of
 

those out to see if everything was according to all
 

there. And that's some of the things that we have
 

talked about in the past is maybe taking a
 

percentage -­

DR. ZIEMER: And again, that probably is
 
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part of the case selection process.
 

MR. PRESLEY: Right. And that will be part
 

of the case selection process also, to intertwine.
 

DR. ZIEMER: Right.
 

MR. GRIFFON: You know, just for your
 

information in those overheads there is -- there is
 

page 4 -- yeah, the July overheads behind the three
 

contract parts. Page 4 has a couple of overheads on
 

case selection and stuff that we had talked about in
 

the working group preliminary stuff. And I think
 

what we're talking about as far as stratification is
 

the -- the second bullet of the first overhead
 

there, it talks about some stratifications we were
 

considering. I'm not sure that's all of the
 

appropriate ones, but that's what came out at the
 

time.
 

DR. ZIEMER: Very good. Okay. Who's next? 


Case selection process as you have it here gives
 

some of the parameters: the site; the exposure
 

type; cancer type; and so on. It gives the
 

percentage of cases, but I assume, Jim, that you
 

were talking about a little more specificity beyond
 

this -­

DR. MELIUS: Oh, sure.
 

DR. ZIEMER: -- even the actual process now.
 
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DR. MELIUS: I think there are like three
 

levels to this. One is an estimate of numbers that
 

would be appropriate for the task order, given our
 

overall sampling scheme, whatever we want to call
 

it, for case review. Secondly is a way the group
 

could work out how would the cases be selected, a
 

procedure given the data base, given how things are
 

being processed and so forth, a way for -- a method
 

for case selection. And the third thing is the
 

actual procedure, the actual selection of the cases. 


Now, that may be a separate, because that's after
 

the task order is awarded and we have to decide is
 

that something that the Committee does, is that
 

something the Committee has to do, which many of
 

these things seem to be, or can that be done by -­

will we have another workgroup that would do -- be
 

tasked just to do that, and is that appropriate.
 

DR. ZIEMER: And that, in fact, is one of
 

the issues that we have -­

DR. MELIUS: Yeah.
 

DR. ZIEMER: -- to decide.
 

DR. MELIUS: Right. 


DR. ZIEMER: Well, given that we're going to
 

do 37 cases of something or other, how are you going
 

to actually choose them?
 
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DR. MELIUS: Yeah. Right. A procedure for
 

doing that, and then third, just actually
 

implementing that at the time when it needs to be
 

implemented. And I don't think that is something
 

that's easy to -- that we should be, in fact,
 

delegating to NIOSH or whoever is doing the
 

contract, or do they want to be involved in that
 

part of it.
 

DR. ZIEMER: No, that's -- that's a Board
 

activity purely under this particular task.
 

DR. MELIUS: Yeah.
 

DR. ZIEMER: Once the -- once the cases are
 

selected, and we have identified the cases available
 

and we have a process in place we've agreed to,
 

that's sort of a one-time thing, but it can be
 

tweaked as you go along. We have a procedure for
 

the selection of cases, and now you have before you
 

X number of cases, now what happens?
 

MR. GRIFFON: Now -­

DR. ZIEMER: Okay. I mean we know
 

conceptually what happens, I want to know what
 

really happens.
 

MR. GRIFFON: Oh, what really happens, I
 

mean it does depend on the type of review I guess,
 

but if you had a pile of Basic Reviews -­
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DR. ZIEMER: Let's start with Basic Reviews.
 

MR. GRIFFON: Right. Well, I think first,
 

you know, there's the question of how this material
 

can be delivered to the auditor; whether it has to
 

be D-identified and I believe it has to be 


D-identified, so whatever cases we select are 


D-identified, and then for the Basic Review I think
 

we're only looking at the -- I'd have to go back to
 

all these detailed, all of our parts of the Basic
 

Review, but I think one's first step would be that
 

the auditing contractor would get a disk copy, or
 

whatever form, from NIOSH of the D-identified
 

version of that case, the entire administrative
 

record, along with, I guess, the final decision for
 

the Basic Review because they're not going to -­

it's not a Blind Review, they're going to see the -­

that's one starting point I can think of is that
 

they're going to get that.
 

DR. ZIEMER: And Jim, if -- Jim Neton, if
 

you have comments to add to this, jump in, but I'm
 

trying to get at questions like: Is this delivered
 

to an individual who is the contractor? Is this
 

delivered to a Board member, through them, in
 

consultation with the contractor does something -- I
 

mean at some point we've got to get very specific
 
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what happens. And we're not going to solve this all
 

today, but I want to get these questions before us,
 

so we -- we have some direction as we go forward. 


We may not even be able to finish this tomorrow, but
 

we need to start framing out the process, and try to
 

identify -- and we may have to have a working group
 

actually step through this and make some block
 

diagrams. But it's almost like a paper flow thing.
 

MS. MUNN: Yeah, it is. Yeah.
 

DR. MELIUS: I also think that some of us,
 

because I think the question comes up as to what
 

this whole (inaudible) Board members are involved in
 

each individual review. 


DR. ZIEMER: That's exactly what the
 

question is. We can't just -- we've got -­

DR. MELIUS: But -- but -­

DR. ZIEMER: -- that's floating around here. 


We need to -­

DR. MELIUS: But that's also going to be
 

dependent on what the flow of cases is, the task and
 

the issues we've just been talking about, that if
 

there's a large number of cases early on -- for
 

example, I could see where we set up the process so
 

that Board members would be more involved early on,
 

so that we get more familiar with the process, and
 
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209 

so -- and then as the reviews go along the Board
 

members might want to be less involved. But all of
 

that is going to float or, you know, involve how
 

many cases there are, how much work there is, and to
 

do with -­

DR. ZIEMER: Obviously we can modify this as
 

we gain experience. We're going to be operating
 

sort of like Jim has been, as we gained experience
 

we'd start modifying. But you have to have a
 

starting procedure, so you have to have something to
 

modify.
 

MR. GRIFFON: I guess the initial scheme was
 

to have Board members working with the contractor,
 

some sort of panel, and how that's constructed, you
 

know, if we had designated assigned panels, I'm not
 

sure that's going to work for people's availability
 

and things like that. 


DR. ZIEMER: And we have to think about -­

MR. GRIFFON: Right, yeah.
 

DR. ZIEMER: -- availability, and where is
 

this going to occur physically -­

MR. GRIFFON: Right.
 

MS. ROESSLER: Yes.
 

MR. GRIFFON: Right.
 

DR. ZIEMER: -- are people traveling
 
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somewhere, or -­

MR. GRIFFON: Right. Now the model we had
 

discussed we had discussed in the working group -­

in the previous working group was to have the -- the
 

idea was to have the panel -- actually, I think I
 

put it in some of the estimates and stuff we talked
 

about. The Board members that were on the panel
 

assigned to those reviews would -- would plan on
 

coming to the Advisory Board meeting a day early or
 

something like that where they could meet with the
 

subcontractor and work through and see -- and we're
 

really relying on the subcontractor to do a lot of
 

the detail work. I would think as far as
 

documentation though, like the administrative record
 

or whatever for cases that are being reviewed my
 

notion would be that these things could be mailed. 


I think that's -- that would be legal, so I could
 

see CDs going out to the contractor and to the panel
 

members for that -- that were responsible for that
 

case. And maybe some process has to be worked out
 

that they be returned back to NIOSH at the end of
 

those case reviews, I don't know what the rules
 

would be there, but, you know, I don't see that you
 

have to physically come to -- everybody would have
 

to physically travel to NIOSH to get these cases and
 
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211 

sit and review them all at once. They could have
 

them back at their offices and collect it at a -­

and come back to a meeting to collect it, especially
 

for the Basic Review, which is the lower level
 

review. 


DR. ZIEMER: Robert?
 

MR. PRESLEY: If everybody got a CD, the
 

two-person, three-person, four-person, five-person,
 

whatever the panel is; we had talked about coming in
 

a day early, the panel, taking the instruction from
 

the contractor, and if everybody said that was fine,
 

then we would come in front of the Board, the full
 

Board and say, this panel recommends that this dose
 

reconstruction either be accepted or rejected at
 

that time. And if it's -- I see it as accepted, it
 

goes; if it's rejected, then we've got a problem.
 

MR. GRIFFON: And what I could -- the way I
 

saw that panel working there is that if the
 

contractor came back in and we try to do it
 

sufficiently so that we could have maybe, you know,
 

five, ten, whatever number of cases that we can look
 

at at one time, not just one case at a time; you
 

look at five cases and maybe you say well, four of
 

these we're in agreement with you, we're going to
 

present that to the Board, the overall Board, and
 
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the Board can rule on it. But one, we'd like you -­

we have these questions, and we told the contractor
 

to give us some more information and, you know, do
 

some further work on this one and report back to us
 

at the next meeting, you know, something like that
 

might evolve, that way the panel is digging into the
 

cases a little deeper than the overall Board, so
 

that's kind of how I envision that working.
 

DR. ZIEMER: Other comments at this point? 


DR. MELIUS: Also, I think you have this
 

process sort of practically that maybe it's a series
 

of there's a workgroup appointed that's panel one;
 

panel one meets between -- before meeting one;
 

reports back -- we're not going to have, you know, I
 

don't think four panels meeting before each meeting,
 

so it's going to be done sequentially. Now, panel
 

one, if we follow Mark's sort of protocol here,
 

panel one may have some leftover cases that aren't
 

resolved by -- by meeting one, so those would be
 

deferred to meeting two, and panel -- you know, and
 

I -- and those are hypothetical, I think we still
 

have to work out the logistics of -- of how that
 

would actually occur. And then also, these type of
 

reports get, you know, what are we accepting at
 

meeting one, or do we really have to have panel one
 
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213 

meet before the meeting -- before meeting one, so
 

that there's really time for a report because I
 

think we need to be accepting a report on the -- I
 

mean the full Board has to approve a report on
 

accepting a report on this. And then have some way
 

of summarizing that, I think, of that review process
 

which is really an overall Board function. I would
 

presume we would do that with the help from the
 

contractor, but.
 

MR. GRIFFON: What Jim just said was -- it
 

sort of summarized our conversations where we talked
 

about these rotating panels, and I think that does
 

make sort of sense that at each next meeting we
 

might want to then say okay, we've got these cases
 

up and running and we need a panel to work -- for
 

the next meeting to work with the contractor on
 

these certain cases. I think we might have to do it
 

like that because then -- then Board members could
 

decide, you know, who is available; secondly, there
 

might be conflict of interest issues where we can't
 

review certain cases because of our personal
 

backgrounds, so we could assign panels sort of at
 

each meeting, sort of ad hoc selection of those
 

panels moving forward.
 

DR. ZIEMER: When you say rotating panels,
 
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there wouldn't be a certain panel that's always made
 

up of the same combination of Board members, it may
 

be some -­

MR. GRIFFON: That's sort of the way I
 

would, yeah.
 

DR. ZIEMER: Roy.
 

MR. DeHART: I think we had talked about in
 

the group a panel of three basically trying to meet
 

together, but that could be changed of course. What
 

I would like to see us flesh out a bit is -- is
 

what's happening with the panel when it meets with
 

the contractor and what, as Jim has implied, what is
 

the report. I had not envisioned a great report
 

coming out -- out of that. The effort was to look
 

at the work that had been done by the contractor and
 

if there is agreement, that's it. And if there is
 

issues, then it's back to the contractor to rework
 

until there is agreement, and then presented to the
 

Board. But from what Jim was saying it implied some
 

report of depth might be coming out of that.
 

DR. ZIEMER: Well, part of what you're
 

raising, actually the question: What is the nature
 

of the report that comes out of the panel? I think
 

that's a very important part of the audit. It's not
 

necessarily the issue of should compensation have
 
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215 

been paid or not, it may be the issue of -- and the
 

bottom line might have been correct, but if we start
 

to see things like incorrect assumptions are being
 

made, or unsupported assumptions are being made, or
 

something like that, then you start looking for
 

patterns. So it seems to me the report has to be
 

dealing with the nature of what's being done and how
 

well that is being done. Certainly part of the
 

bottom line is, is the correct decision made. But
 

we're not sending things back for redoing of the
 

decision, we are looking for -- and you might
 

actually, I guess, conceivably have a case where you
 

say, you know, this person should have been paid off
 

and they weren't, in which case you might actually
 

have a way to reopen it, but that's a separate
 

issue, but if -- if your finding some flaws in the
 

methodology, I guess is what you're looking for. 


And so we may have a series of things, and I'm
 

trying to remember if you addressed this. Is the
 

report -- or was the dose reconstruction, were the
 

assumptions valid -­

MR. GRIFFON: Yeah. Yeah, we have it in
 

there.
 

DR. ZIEMER: -- was the site information
 

data properly used -- weren't there -­
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MR. GRIFFON: Yeah. Oh, yeah, they're all 


-- they're all in there.
 

DR. ZIEMER: They're in there.
 

MR. GRIFFON: I -- I guess I envisioned this
 

report as being -­

DR. ZIEMER: Well, that would be the basis
 

of the report, would it not?
 

MR. GRIFFON: Yeah, I guess I envisioned
 

this report being fully developed when the
 

contractor came to these panel meetings. And the
 

notion of the panel at all, I mean you could say
 

well, why have the panel. I thought the intent of
 

having the panel was that they would get the CDs
 

ahead of time with all this data that the contractor
 

is reviewing, and would have access to the
 

contractor doing that review via phone, most likely. 


But they could have access by e-mail or phone, you
 

know, to ask questions are you looking into this, or
 

whatever. Then when the contractor comes to meet
 

with the panel the day before the Advisory meeting,
 

they'd go through their entire report, and if I'm on
 

the panel I can say well, you know, wait a second, I
 

was looking at the administrative record and, you
 

know, these pages, you know, I don't see you really
 

addressing this issue in your report at all, you
 
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217 

know, so the panel members have had -- have had more
 

time to review the specific cases, and then they can
 

-- they can, you know, they don't replace the
 

Board's vote, but they'd have more time, you know,
 

and the Board -- it was just to alleviate from
 

having every Board member review every case, 


you know, so.
 

MR. DeHART: Let me give you an example of
 

how a review might happen. We deal with medical
 

records; we have a checklist basically that we just
 

go down and make sure that you know there's a name,
 

and there is a diagnosis, and evaluations, and a
 

proper treatment appears to be made; boom, boom,
 

boom, we'd check it off and if that's it, then this
 

one would be completed in terms of its review and
 

recommended to the Board. But if there's problems,
 

we would address those and ask the contractor to try
 

to make those changes.
 

DR. ZIEMER: Thank you. Tony, and then Jim.
 

DR. ANDRADE: Given what's in the definition
 

of Basic, Advanced, and Blind Review Requirements, I
 

believe that answering the questions or addressing
 

each and every specific item there, even in a view
 

graph, would comprise a report. But if we have a
 

panel to check the quality of the auditors who are
 
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218 

checking the quality of the contractors, then I
 

think we're going to be duplicating efforts and
 

wasting time, so if the panel convenes to insure
 

that these things have been done in a checklist
 

method, then I think that would really be all that
 

is necessary and probably minimize people sitting on
 

a panel's time and effort.
 

DR. ZIEMER: Jim. And then were you going
 

to respond to that, Mark?
 

can. 

DR. MELIUS: If you want to go ahead, you 

MR. GRIFFON: 

DR. ZIEMER: 

No, go ahead. 

Jim. 

DR. MELIUS: Yeah, I would see this working 

off of form and I -- and I think it would behoove us
 

as a Committee, so perhaps we develop the form so we
 

can -- cause we have to give that at the time these
 

task orders go in place, and we don't want to make
 

that the first task order or we delay the whole
 

process, so we can't let the contractor do that, so
 

that's one. And I think the issue only comes up -­

there's an issue that would come up, it may not
 

always come up, but would come up if we find a
 

problem or a potential problem. That's when there's
 

the issue of the report and maybe it's also when the
 
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Advisory Board member would sort of get more -- we'd
 

have to judge how serious this is; is it a pattern,
 

and then there would be a need to be some report
 

from the panel that would say we have reviewed 10
 

cases, whatever it is, that we found problem A, and
 

we'd have to have some way of putting all those
 

panel reports together, you know. And it may be
 

that the kind of problem that may be found may be
 

only serious if it's a pattern or, you know, there's
 

lots of different ways to characterize that. But I
 

don't see us doing large reports or long reports on
 

each case or anything. It would -- it ought to work
 

off of form, and I think we have to spend the time
 

developing a comprehensive or a complete form that
 

we're satisfied with.
 

DR. ZIEMER: Thank you. Mark, you were
 

going to respond to Roy's comment, or Tony's.
 

MR. GRIFFON: I was.
 

DR. ZIEMER: You were.
 

MR. GRIFFON: I guess that's why I let Jim
 

go first because I was pausing on this one, but I -­

you know, I don't -- the intent of the panel,
 

certainly the reason we're looking for a contractor
 

for this Advisory Board is to pull expertise into
 

this Board to actually do these reviews. On the
 
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other hand, it is the Board's responsibility to do
 

this -- this oversight task, so we are responsible
 

for these findings, so I'm listening to the
 

checklist comment and, you know, I'm thinking of the
 

model on NIOSH's side, which is that, from what I
 

understand NIOSH has -- ORAU is doing the bulk of
 

the dose reconstructions; NIOSH is reviewing every
 

single one. I think that we're having a contractor
 

do all the dose reconstructions. I don't -- and it
 

wouldn't be as extensive of a review, but I think -­

maybe a checklist is enough -- but I think there's
 

got to be some sort of review by the panel just to
 

make sure that the Board is comfortable with the
 

final product. 


MR. PRESLEY: Mark, isn't that what we're
 

going to do on the Blind ones?
 

MR. GRIFFON: Yeah, I haven't got that far.
 

DR. ZIEMER: On the general review,
 

certainly it was my understanding that we're not
 

recalculating, we, the Board, we're not doing dose
 

reconstructions.
 

MR. GRIFFON: Right. But I mean I -- I
 

guess I just envisioned it as being -- the panel
 

members involved in it as being more than our -- the
 

Board's contractor comes back and we have a
 
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checklist that says they looked at basic review
 

items A-1, check; A-2, check. I mean I think the
 

panel should -- should look at their report and -­

and make some kind of determination as to whether
 

they -- the contractor addressed it adequately for 


-- for the Board to make their final decision as to
 

whether the whole case was reviewed appropriately,
 

you know. That doesn't mean that they start from
 

scratch and do all the work the contractor did, but.
 

DR. ZIEMER: Okay. We have a comment from
 

Mike, and then we'll get back to Tony.
 

MR. GIBSON: I guess Mark was kind of
 

addressing what I was thinking, is, you know, if we
 

have rotating Board members for different cases,
 

each one of us will probably have a different idea
 

of what's an acceptable site profile; what's
 

acceptable default parameters; so it looks like to
 

me it could keep us from being consistent if we just
 

have a basic, generic form that we check off unless
 

we really define, as a Board, what adequate site
 

profile, you know, which gets us into another level
 

of the work, so. 


DR. ZIEMER: Keep in mind we're -- we're
 

really not asking quite the question of what's an
 

adequate site profile, we're more asking something
 
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along the line: Did the dose reconstructor use the
 

information properly in reconstructing the dose? 


Many of these site profiles may indeed be inadequate
 

from one point of view, but may be adequate for
 

doing a particular dose reconstruction, so some of
 

these -- some of these questions, you know, have to
 

be answered in the context of particular cases so
 

that if there's -- if there's an issue with a case,
 

then you raise it and say, you know, they made some
 

assumptions here that you can't make based on what's
 

available. And I think you're quite right, Mike,
 

that you may have a better feel in some cases for
 

whether that's the right, and I think the Board does
 

bring its view to the -- to the process. It's very
 

interesting, just -- I just talk generically, you
 

know, Boards nowadays are getting a lot of scrutiny,
 

particular those that have audit functions. I'm on
 

a -- I'm on a different Board right now that is
 

setting up an audit committee to audit the auditors,
 

and you know why that's come about. But there are
 

Federal Regulations now that Boards have to audit
 

their auditors, and it's -- the auditing function of
 

a Board Audit Committee is not one of doing the
 

audit. They are looking to certify that the
 

auditors followed the proper audit procedures that
 
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they say they're following. There is a point at
 

which you have to take people's word when they say I
 

did this, and they show you how they did it, you
 

know, somebody can still fool you, but since the
 

Arthur Anderson case has come about, you know,
 

there's -- people are checking the auditors. Now,
 

Boards even have to determine whether their auditing
 

committee is properly auditing the auditors, so it
 

keeps moving back a level. But I think there is a
 

sense in which we have to take the responsibility as
 

a Board to do this function. We -- we are -- we are
 

doing an audit, and it's not our contractors, they
 

are helping us do the audit, but you're quite right,
 

it's our responsibility; ultimately if there's a
 

problem, it falls back on us.
 

I'm off my soap box, and who is next? I
 

think Tony was next, and then Jim.
 

DR. ANDRADE: Again, I envision the report,
 

or a report to a panel, whatever body, to be -- to
 

include statements and/or groups of statements that
 

address the various elements that the contractor was
 

assigned to do; whether it's basic, advanced, or
 

blind. So it's fairly simple insofar as what
 

content should be -- should be there. If the -­

okay, let me -- let me digress to an example and go
 
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back to the example that Mike used that we may be
 

uncomfortable, or one of the panelists may be
 

uncomfortable about the adequacy of a site profile. 


Well, the nice thing about the way the system is
 

functioning is that inadequacies usually lead to
 

greater uncertainties in dose reconstructions;
 

therefore, inherently the system self-corrects. In
 

other words, it becomes more user friendly as the
 

uncertainty grows, and that can be pointed out; that
 

can be information that's fed back to the -- to the
 

associate universities, etcetera, so I think that's
 

a self-correcting sort of issue. I just wanted to
 

mention again these contractors here are
 

incentivised through the contracting process itself. 


In other words, they're being paid to find mistakes,
 

to find errors, to find shortcomings. That's where
 

-- you've got to keep that in mind as well.
 

DR. ZIEMER: I'm not sure we pay any bonuses
 

if they find one.
 

DR. ANDRADE: No, but -- but there are
 

reasons why these people are bidding, okay, and so
 

let's not forget that.
 

DR. ZIEMER: Thank you. Jim, you had
 

another comment.
 

DR. MELIUS: Yes.
 
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DR. ZIEMER: Then we're going to close it
 

off for now.
 

DR. MELIUS: Okay. I think we could develop
 

a form based to some extent on what we've already
 

written here that would be used by the contractor in
 

doing the review, used by the panel in meeting and
 

discussing that review would capture that
 

information, and something that I do agree with Tony
 

that we're going to -- they are going to be finding
 

things, and I think the part of the panel function
 

is going to be sort of determining how serious that
 

is, understanding that -- that, and then making some
 

sort of assessment out of it, and then we have to,
 

as a panel or a Board make an overall assessment of
 

that. But I think if we get into forms that we're
 

all comfortable with, I think that we can make the
 

process work without, you know, generating a lot of
 

paper that's not useful or putting too much of a
 

burden on us to do the actual dose review. And it
 

is quality assurance, and so it will actually, I
 

think, tend to find problems or potential problems.
 

DR. ZIEMER: Thank you. With that comment
 

we're going to end the discussion on this topic
 

today. We will be back to this topic again
 

tomorrow.
 
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We do have on our Agenda a Public Comment
 

Period. We have several individuals who have
 

requested their time to comment. We will begin with
 

-- let me see if I can pronounce these right: Is it
 

Hans Behling, S. Cohen & Associates. Hans, did I
 

pronounce your last name correctly?
 

MR. BEHLING: Yes.
 

DR. ZIEMER: Thank you. Please come and
 

address the group.
 

MR. BEHLING: I really don't have as much of
 

a comment as a question, and the question -- there's
 

two questions that somewhat relate to each other and
 

they do involve a NIOSH/IREP dose model, and perhaps
 

somebody here in the Advisory Board can answer the
 

question. 


When you talk about internal exposure from,
 

let's say a rem of 31, the issue in the scientific
 

literature has been based regarding the efficacy for
 

a unidose of internal radiation to include thyroid
 

cancer as opposed to external radiation. In other
 

words, a rad is a not a rad, it is not the findings
 

in the external or internal, and the ratio between
 

the efficacy of internal to external has been in the
 

scientific literature defined as being a part, it's
 

a part of 10 to 1 or -- or essentially 1 to 1. Does
 
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the particular IREP model address that issue of
 

efficacy once the dose for internal and external
 

exposures to the thyroid has been added to each
 

other? That's my first question.
 

DR. ZIEMER: We can probably have Jim Neton
 

answer that. Go ahead with your second -- or Jim go
 

ahead and.
 

DR. NETON: I'm not sure I really understand
 

the question. You're talking about external
 

exposure in a gamma radiation field added to some
 

internal exposure from like the data radiation that
 

one might receive, something like that?
 

MR. BEHLING: In terms of the PC
 

calculation, if one say had external, whole-body
 

exposure that includes the thyroid, let's say if 10
 

rads or rem, and then from an internal exposure to
 

ion like 31, you also have 10 rems -­

DR. NETON: Okay. Yeah.
 

MR. BEHLING: -- and how are they added to
 

each other, and what is the efficacy assigned to
 

internal in terms of risk coefficient for the
 

private citizen?
 

DR. NETON: Okay. The answer to the first
 

part of that question is they are treated totally
 

independently; IREP allows for input for both an
 
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internal dose component and an external dose
 

component; it's on an annual basis. I don't know
 

the exact value for the risk coefficient for
 

internal versus external, but the external was
 

modeled after the Hiroshima-Nagasaki survivors. The
 

internal risk coefficient is also modeled after the
 

Hiroshima/Nagasaki, but the dose calculation is not. 


I mean that's done separately using the ICRP models,
 

so the answer is we do account for both internal and
 

external. The efficacy model though, the risk
 

coefficients though, once the dose is calculated is
 

based on an external -- well, that's not true -­

there is -- there is some medical studies, or a few
 

medical studies that were incorporated into
 

developing that risk coefficient, and I guess I'm
 

not sure exactly how much weight was given that. 


I'd have to look into that to get back to you.
 

MR. BEHLING: The second question is also an
 

important one related to iodine and the potential
 

thyroid exposure. We all know that the uptake
 

fraction, that is the transfer from blood to thyroid
 

for iodine is heavily dependent on a dietary intake
 

of cold iodine. In other words, a person, you have
 

two people; one takes a dietary iodine intake of
 

let's say 300 micrograms per day, and the other
 
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person only 100 micrograms; expose those same two
 

individuals with all other parameters being equal to
 

an airborne environment or ingestion; the person who
 

has a lower dietary intake has a higher FS-2 or
 

uptake fraction, and as opposed to the person with
 

the 300 micrograms. Now, we do know, and I've done
 

a lot of work on this area, that the dietary intake
 

of iodine has shifted over the years since the
 

introduction of iodized salt. Also, there are
 

geographical differences that separate East Coast,
 

West Coast. The most recent data I've seen is that
 

West Coast people, on the average, may be consuming
 

up to 700 micrograms of iodine a day, which will
 

certainly impact the -- the FS-2 fraction for
 

thyroid doses. And so we have a variation here over
 

time and space that deal with the dietary iodine
 

intake that has a pronounced effect on the actual
 

dose calculation. What is the issue that will be
 

addressed on that level?
 

DR. NETON: That's a difficult question, but
 

the answer to that is that we use the standard
 

default ICLP metabolic values for -- for uptake of
 

iodine. I guess in just quickly thinking about your
 

comment, those that were rich with the iodine -­

diets were rich in iodine we would be actually
 
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overestimating their dose. Those that were
 

deficient, we would be underestimating, but I don't
 

think that we really have any way of reconstructing
 

-- a good way of reconstructing their iodine intake
 

at the time of the occupational exposure. This is
 

the non-environmental exposures, so the answer -- we
 

don't address it, we use the standard default;
 

however, models do allow for us to incorporate
 

uncertainty into the dose calculation itself. To my
 

knowledge, we have not done an iodine exposure dose
 

calculation yet, but we certainly could incorporate
 

that into the uncertainty in the dose dosimetry.
 

DR. ZIEMER: But keep in mind also, in the
 

case of occupational workers you -- you may actually
 

have thyroid uptake measurements, which give you the
 

actual burden of iodine in the thyroid, so you -­

you don't have to depend on any metabolic models for
 

those. And many of the facilities using iodine
 

would have that. I'm not sure about the older
 

cases, but -­

DR. NETON: That's a very good point. If -­

if the exposure got to the point where there was a
 

significant dose of thyroid, a person, not more than
 

likely, but probably could have been -- would have
 

been monitored and we would have the exact value of
 
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a good approximation of the iodine in their thyroid. 


For those lesser cases, we tend to be very
 

conservative or claimant favorable in our approach,
 

and we'd certainly more than likely overestimate the
 

amount of dose to the thyroid.
 

DR. ZIEMER: Thank you. Any of the Board
 

members have questions on this issue?
 

Okay. Next we will hear from Denise Brock
 

with United Nuclear Weapons Workers of the St. Louis
 

region. 


Ms. Brock.
 

MS. BROCK: Hi. I'm Denise Brock, and I'm
 

going to read from this because I'm extremely
 

nervous. 


I am from St. Louis, Missouri, and my father
 

was Christopher Davis. He was an employee of
 

Mallinckrodt Downtown Destrehan Plant for 16 years. 


In 1967, he was diagnosed with lung cancer and after
 

a complete pneumectomy, and years of suffering, he
 

passed away. 


My mom, Evelyn Coffelt, is 70 years old. 


She is a claimant and she filed two years ago. Up
 

until about a month ago my mom worked full-time just
 

to make ends meet, but due to failing health she has
 

been forced to quit her job.
 
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My mother is living barely above poverty
 

level, and I was hoping that her claim would be
 

handled expeditiously, and that she would be
 

compensated. I am here on her behalf and on behalf
 

of all of the Missouri claimants. 


Prior to coming here I had called two
 

meetings; the first consisted of about 60 people,
 

which kind of surprised me, I thought I'd end up
 

with about 15 or 20; and the second, I actually had
 

over 300 people, including Congressional staffers
 

and Federal Officials. And one of those Federal
 

Officials is here today; Dr. Jim Neton, and I would
 

like to thank him publicly, now, for attending; as
 

well as stating that since listening to the
 

discussion today I feel confident in going home
 

knowing that there's an honest effort being put
 

forth by this Board to wade through all of this. It
 

seems to be kind of public opinion from the
 

claimants that maybe they're not going to get paid,
 

and I think sitting here listening to this just
 

shows me that everybody is putting an effort forth
 

and that it's -- there's a lot of intricacies in
 

this. 


I would also like to commend the Paducah
 

Resource Center; they have been a lifeline for
 
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myself and the claimants. 


Since my second meeting, I have been
 

contacted in excess of over 600 people, and that's
 

not including members of the press, the media, and
 

even Erin Brockavich's office. Throughout the
 

contacts of the claimants though, I've noticed that
 

we have all similar statements, concerns, and
 

questions, and in reference to that I have some
 

issues that I'd like to raise with the Board, all of
 

which have really been touched upon today. 


Number one would be the quality of the -­

and I say transcripts, but I'm understanding that
 

would be drafts pertaining to the phone interview. 


For example, my mother had her phone interview on
 

December 12th, and I did record this. It's my
 

understanding that the phone interview is a very
 

integral part of this program, especially dose
 

reconstruction. Knowing this, I have done a
 

tremendous amount of research concerning the
 

facilities. At the beginning of the interview the
 

interviewer's computer went down; she was very nice
 

and very polite, but she did assure me that she
 

could write as fast as she could type, so I
 

continued, and as I said before, I had quite an
 

enormous amount of information about these sites. 

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This time, because it was about my father, I was
 

talking about the Destrehan site, and they worked
 

with Belgian Congo pitchblende. This African ore
 

was so hot that the workers were exposed to not just
 

U238 and it's daughters, but U235, which I
 

understand is rarely found in nature, and all of its
 

daughters; thorium, all three types of radon gas,
 

three types of radium; and I kind of went through
 

all of this with her, even in reference to like the
 

work environment. As I continued, the interviewer
 

conveyed that the Health Physicists were aware of
 

all that the plant consisted of, and felt confident
 

in summarizing. And typically, one might be
 

comfortable with that, but I have heard repeatedly
 

from claimants and other sources that the data is
 

still being recaptured, and that there might not
 

have even been a site profile done yet. My question
 

is: Was she correct -- is the interviewer correct,
 

would it -- has there been a site profile done, and
 

do they know everything they need to know, or on the
 

flip side, maybe would that be incorrect, and maybe
 

she would be remiss in taking -- not taking down
 

everything that I had stated to her?
 

DR. ZIEMER: I'm wondering if any of the
 

NIOSH staff are able to answer that, and if not
 
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right now, they will certainly be able to shortly.
 

DR. NETON: Yeah, I think I can address that
 

partially anyways.
 

It sounds like -- let's go back. The
 

interview is really to try to elicit the information
 

that's specific to the claimant that may not be
 

known about their exposure scenario, you know, where
 

they worked in the plant, what type of material the
 

claimant worked with individually, so that's really
 

one of the -- one of the main intents of the -- of
 

the interview itself. If a claimant does have site-


specific information they developed on their own
 

that is somewhat voluminous in nature, that should
 

be provided to us; it could easily be provided to us
 

under separate cover, but it really is not the
 

intent of the interviewer at that point to go over
 

and develop site profiles during the interview. So
 

I think maybe we have a little bit of
 

misinterpretation of what the interview is actually
 

accomplishing. Do we have site profile for
 

Mallinckrodt done? No. I mean we're working on it,
 

there's a lot of information we have, but there's a
 

lot we don't have. Anything that you would have or
 

a claimant, related to the Mallinckrodt site, we
 

would encourage that to be submitted, and that's
 
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more than likely what the interviewer should have
 

said, is, please, you know, submit that under
 

separate cover, when it's a volume, if it's not
 

meant to be taken down on the telephone. Anything
 

that is specific though to the claim itself, it
 

could help elucidate the actual dose to your father
 

would have been of value, and it -­

MS. BROCK: He had three separate job 


titles -­

WRITER/EDITOR: Use the mike, please.
 

MS. BROCK: He had three separate job
 

titles, so I'm assuming, and I actually had which
 

plant he was in like 4, 6, and 7, those different
 

areas, so if I was being specific with what were in
 

those areas, would that have been something the
 

interviewer would take down? I mean I'm just
 

confused, or do I send that in with my hard copy?
 

DR. NETON: No. If you knew specific job
 

titles, and locations, and type of materials, which
 

are actually part of the interview. I mean that is
 

the script the person should repetitively go
 

through, and that's why we computerize it; what's
 

the job title; what type of radioactive material;
 

what plant; what type of radioactive materials; that
 

should have been captured in the interview, so if it
 
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wasn't, then, you know, maybe we need to revisit
 

that.
 

MS. BROCK: And I can send that in.
 

DR. NETON: Oh, sure. Absolutely. Or we
 

could arrange for another follow-up interview if you
 

have additional information to add.
 

MS. BROCK: And, let's see, that brings me
 

to my -- to my second one, would actually be the
 

issue of dose reconstruction. I have a letter with
 

me to one of the claimants from the Department of
 

Labor stating that dose reconstruction could take
 

months, even years. And I'm assuming that's
 

accurate, and I just would like to say that that is
 

very disheartening because these claimants do not
 

have months or years; they are dying daily. Even
 

though I do understand there's a process that one
 

must go through, and especially after being here
 

today, you know, I can see that NIOSH is actually
 

making great efforts in this. And I can empathize
 

with all sides, but when it's obvious that workers
 

were endangered, and they were, that's a given, and
 

when you know that they were exposed to some of the
 

most hazardous materials known to mankind -- and I'd
 

like to make reference to an exit interview of
 

Merril Eisenbud conducted January 26, 1995, by
 
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Thomas J. Fischer and where Mr. Eisenbud states that
 

Mallinckrodt was to be -- is one of the two most
 

worst facilities. And I also had a concern about,
 

if like in my father's case, if the Department of
 

Energy, it's my understanding, could not find
 

specific things in reference to my father, then when
 

you dose reconstruct that, I'm assuming you use
 

coworker data. And that kind of gives me grave
 

concerns because, as I said, he had numerous job
 

titles, and I'm wondering at that point if that's
 

possible to even -- even do that if they worked
 

seven days a week, 14-hour shifts, and maybe he was
 

in, you know, different areas, is that possible to
 

even do that. And then I wonder when does dose
 

reconstruction not become feasible because my
 

ultimate goal would be -- again, I think I've talked
 

to several people -- to make Mallinckrodt a special
 

exposure cohort, so I mean is there -­

DR. NETON: The use of coworker data may not
 

be possible. Clearly, if we can't identify
 

coworkers for your father in the facility, and then
 

we would go back one level, which is in our Rule,
 

and revert to the exposure models essentially, which
 

we would try to generate from the type of materials
 

that were there, and their concentration data we may
 
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have, that sort of thing. Once we develop an
 

exposure model of that type, if the claimant, in
 

this case it might be your father, could be placed
 

in the environs of what that exposure model covers,
 

and that would be the basis for his dose
 

reconstruction. We're working on approaches like
 

that at other facilities, you know, I can't fill in
 

much more detail on that other than sometimes
 

coworker data may not be possible. And if we don't
 

the source term at all, you're right, at some point
 

we would say it can't be done. We haven't done that
 

yet, but it is a distinct possibility and it's
 

provided for in our regulations.
 

MS. BROCK: So then is it possible then like
 

after a phone interview like my mother had, if
 

perhaps you can't find all of that, and you can't -­

is it possible to dose reconstruct without that
 

Mallinckrodt model? I mean is that possible, or is
 

it something she's going to have to wait for?
 

DR. NETON: That sort of gets to the issue
 

of how long it takes to do a dose reconstruction. 


And we need to get sufficient information, obtain
 

sufficient information to develop some type of a
 

model. Once we do that, then we have to make the
 

decision is the model sufficient to -- to calculate
 
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doses for people in the areas in plants that maybe
 

your father had been, so we'll just have to wait and
 

see. I guess I can't fill in any more details on
 

that. I apologize, but I can't give you any more
 

specifics at this time.
 

MS. BROCK: My last issue is really a policy
 

issue. And if I might use a hypothetical -- and
 

bear with me. Say you have -- and I know we've
 

addressed this -- or you've addressed this with the
 

smoking. If you have two workers with the same
 

exposure, and I don't know, maybe say 60 rem or
 

whatever would be compensable, both have lung
 

cancer, and one is a smoker and one is a nonsmoker,
 

how is it equitable to have that smoker at an
 

automatic disadvantage if they're exposed to the
 

same thing, same amount of time, and they both have
 

lung cancer?
 

DR. ZIEMER: Russ Henshaw is going to
 

volunteer to answer that.
 

DR. NETON: No, I don't want to take a shot
 

at this.
 

MR. HENSHAW: Well, that's a question that
 

does come up from time to time, and I'm not sure how
 

best to explain the theory behind that in IREP. 


This may be -- somebody please yank me away if I get
 
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too wordy here. But just to go back to the
 

beginning, we have the Japanese cohort that the
 

base-line rates are taken from and the excess
 

relative risk of smoking for lung cancer. That
 

Japanese cohort consisted of, on average, moderate
 

smokers. So now we have a cohort of people for whom
 

our excess relative risk for lung cancer is based on
 

of moderate smokers, and we have claimants who -­

some who were smokers and some who were nonsmokers 


-- some were smokers and some were not smokers. The
 

probability of causation -- and further we're
 

mandated by the legislation to calculate the
 

probability of causation that a worker's cancer was
 

caused by his or her radiation exposure, so now you
 

have the case of two individuals with similar
 

exposures; one's a smoker, one's a nonsmoker. And
 

the hypothetical scenario you present is where under
 

those circumstances one is compensated and one is
 

not, even though they were exposed to the same
 

amount. Well, this gets back to the way the
 

legislation reads, is: Was the worker's cancer as
 

likely as not caused by radiation exposure? And
 

what probability of causation does is calculate the
 

contribution in a probabilistic (sic) way. The
 

contribution of the radiation exposure to the
 
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cancer, the likelihood that that radiation exposure
 

in and of itself caused the cancer. Well, with the
 

nonsmoker there is not -- the smoking is not
 

contributing to that effect, which is -- which is
 

lung cancer; therefore, the probability of causation
 

is higher. For a smoker, we have two contributing
 

factors; one the radiation exposure, one the
 

smoking. So in that case the -- the estimated
 

contribution of the radiation exposure is less. Now
 

getting back to that Japanese cohort -- this
 

probably is making things a lot more confusing, 


so. But getting back to the Japanese cohort, that
 

was a cohort of moderate smokers, so when we adjust
 

for smoking in our lung cancer model, it does two
 

things: It has the effect of decreasing the
 

probability of causation for smokers, and that
 

varies with the category of smoking, but it also has
 

the effect of increasing the probability of
 

causation result for nonsmokers. So now you plug
 

these two hypothetical claimants into the IREP
 

software; on the one hand you have a factor that
 

increases the probability of causation, on the other
 

hand you have a factor that decreases the
 

probability of causation. So in a nutshell, that's
 

how one person could be compensated and the other
 
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one not. Now the issue you're raising is how is it
 

equitable, how is that fair. I think -- I mean I
 

think that sort of goes beyond the science issue and
 

into an issue of policy, but as of right now we're,
 

you know, we're using the science as best we can for
 

the IREP modeling, and it just so happens that
 

there's probably no more substantiated cause of
 

cancer than smoking, that smoking is a cause of lung
 

cancer. So the data is, you know, unequivocal and
 

indisputable about that, and that's why we adjust
 

for it in the IREP model -- you know, at some point,
 

you know, that might change as, you know, that
 

adjustment may change, we may, you know, tinker with
 

the categories if science or new data suggest that,
 

or there could be some other influences that could
 

cause a policy change, but for right now that's -­

MS. BROCK: I know you said it's legislated
 

or mandated through legislation. Is it mandated or
 

is it just to be considered? Is it mandated?
 

MR. HENSHAW: It's not mandated that we -­

that we adjust for -- we adjust lung cancer claims
 

for smoking. I'm sorry if I -­

MS. BROCK: Maybe I misunderstood.
 

MR. HENSHAW: Yeah, it's mandated that we
 

use -- we use the best science available to estimate
 
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most accurately the probability of causation for any
 

cancer model. And for lung cancer, you know,
 

tobacco smoking is the greatest cause of lung
 

cancer, I don't think anybody would seriously
 

dispute that. I mean I understand the issue you
 

raise, I'm not trying to discount that at all, no
 

one here would. I think it's, I guess, an anomaly
 

of the adjustment, if you will, but I don't know.
 

MS. BROCK: Well, thank you. And the only
 

other thing -- can you hear me -- the only other
 

thing that I'd like to add is just a request to have
 

the next meeting, or the special exposure cohort
 

meeting in St. Louis. It would just be really
 

helpful for the claimants there to see what I've
 

seen today. I mean I just think it would make a big
 

difference. I'm telling you, it's impressed me and
 

I'd like to say thank you.
 

DR. ZIEMER: Thank you, very much. Let me
 

ask the Board if anyone has any questions for 


Ms. Brock?
 

DR. MELIUS: Just in a quick follow-up, I
 

think. The issues you raised I think were very
 

good, and certainly two of them, the smoking issue
 

is one that the Board voted on today to put under
 

further review and scrutiny, and I think we'll be
 
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dealing with that in later meetings. Secondly, the
 

issue of what happens when there's not adequate dose
 

information will be dealt with through the special
 

exposure cohort regulations, and the Board was not
 

pleased with the first edition of those, and
 

particularly in this issue of when is there not
 

adequate information available, so hopefully that
 

issue will get addressed also. Hopefully when NIOSH
 

gets these next set of regulations out for review.
 

MS. BROCK: Thank you.
 

DR. ZIEMER: Well, the next one appears to
 

be Richard Miller, whose handwriting -- Richard, did
 

you sign up?
 

MR. MILLER: Yes, I did.
 

DR. ZIEMER: Okay. Then, you're on.
 

MR. MILLER: Good afternoon, and welcome to
 

Charleston. I keep seeing you in these hotel rooms. 


The hotel rooms, with the exception of New Mexico,
 

all look alike. And as Camille said, I wish we were
 

having it at Aiken, so we would have lots of
 

Savannah River workers here. Otherwise, the hotels
 

are kind of boring, you know, we could just do these
 

in Cincinnati, right, Larry?
 

MR. ELLIOTT: That's right.
 

MR. MILLER: But I had a couple of series of
 
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questions for the Board, and the first has to do
 

with sort of leading, I guess, to what happens to
 

the product that the Board generates after it does
 

its review, your audit, or whatever you want to call
 

this. The review contractor shows up and you all
 

develop whatever product it is, your checklist, your
 

evaluation, your audit of your auditor, or whatever
 

the appropriate line is that you're drawing, and
 

then let's just take a hypothetical -- Larry's sort
 

of reading my mind. Do you want to ask this
 

question, Larry?
 

And -- and -- and the -- and the question
 

would be: Let's just say for example, you all look
 

at a case and you find either unsupported
 

assumptions, questionable assumptions, you didn't
 

look at the, you know, your assumptions on particle
 

size are all wrong, and therefore your committed
 

dose is wrong, and therefore, not only does that
 

affect an individual's case, but it might affect a
 

clache of cases that go back. Say you've handled a
 

site profile, and so you've got a whole of clache of
 

those. When NIOSH gets that, you have a set choice
 

points, I guess. One is you can decode the Blind
 

cases that was brought to the Board, which wouldn't
 

know who it was, but you would -- you would probably
 
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have a way to decode it, presumably. And I guess
 

then the question is: Would you have, either
 

yourselves, or ORAU rework it? I guess that's
 

question one, and question two behind it is: Or
 

would you simply say look, we're not going to do it,
 

this is an adjudicated claim, the case is closed,
 

noted; we're moving on with life, we've got 10,500
 

piled up and more are like airplanes on the runway
 

waiting to come in, and just say we're going to
 

rework our procedures going forward. And then third
 

sort of choice, perhaps, is you have to go back and
 

review all of those in that clache, which would be a
 

function -- and then how would you know whether to
 

even accept the advice. In other words, you could
 

say professionally, you know, with all due respect
 

Advisory Board, fly a kite. So that's the question. 


DR. NETON: I'd like to just address
 

maybe one portion of this, and then leave
 

the policy decisions about what we do up to
 

Larry.
 

But I think one thing I would like to point
 

out with your question is that we expect that there
 

are going to be differences in dose reconstructions. 


I mean we have a unique process, we apply it as
 

efficiency process, and we take it only as far as we
 
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need to so that Labor can make a decision. So in
 

your example of particle size for instance, if the
 

contractor, the oversight contractor, the task order
 

contractor that the Board hires comes back with a
 

dose reconstruction that differs by a factor of two
 

because they chose different particle size, but that
 

factor of two might make a difference between one
 

percent and two percent probability of causation, I
 

don't view that as a substantive issue. The issue
 

to the oversight contractor is: Did NIOSH, in my
 

mind, make the correct -- draw the bar on the right
 

side of the line for Labor to make the final
 

decision? So we need to remember that when we're
 

looking at these things. This is not -- these are
 

not exact, accurate dose reconstructions. And I'll
 

stop at that and then Larry maybe address what we're
 

going to do with it if there are substantive issue
 

where maybe a person should have been compensated.
 

MR. ELLIOTT: I love Richard's three-part,
 

four-part questions, you know, he always fires those
 

and then, you know, expects me to remember each and
 

every significant nuance of -- of what question,
 

which order, but let me just start. 


The Department of Labor's regulations, and
 

our regulations both have a clause which allows us
 
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to revisit dose reconstructions that have been
 

completed. That's the clause for DOL or us that we
 

would use to reexamine a dose reconstruction that
 

may have been found to be inadequate or of poor
 

quality. Okay. 


Now whether or not -- I think the second
 

question Jim answered, perhaps. The third question
 

is: Would we just take it and would we ignore it? 


And certainly, you know, the -- the Department's
 

position is this Advisory Board advises the
 

Secretary, and by that fact, gives us advice too on
 

how we do our work. We're going to consider that
 

duly, and depending upon what it is, you know, I
 

can't predict how we're going to go, but -­

MR. MILLER: Well, let me give you the
 

hypothetical with the word "material" associated
 

with it, so that we're dealing with a material
 

issue. I'm not dealing with a question of trivia
 

here, so that at the end of the day let's assume
 

that you got the solubility wrong, so that you
 

really have a question of whether it's compensable
 

or not, even though it's not your job or your
 

contractor's job to be sitting around running IREP
 

all day on the dose models as they flow through. 


Right? At least that's what you tell us. But -­
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but if that's true, and let's just say you got the
 

solubility wrong for whatever reason, and that's a
 

hypothetical, or a series of factors; the energy
 

level of the neutrons, just got it wrong for
 

whatever reason. That set of assumptions or
 

uncertainties are so wide that you, at the end of
 

the day, if you got a case and you get it back and
 

it was material, would you decode that case, decode
 

the Blind case and rework it and send it back
 

through because the claimant would never know that
 

there case was being audited cause they're blind as
 

well, unless they're getting a phone call under that
 

disputed procedure.
 

MR. ELLIOTT: Well, the answer to your
 

question is yes, of course.
 

MR. MILLER: Okay. I didn't know that.
 

MR. ELLIOTT: Of course, we -­

MR. MILLER: I didn't hear that.
 

MR. ELLIOTT: -- would. We're going to -- I
 

-- I don't see any way out of it. We're going to
 

have to help the Board identify what cases are
 

available, and we're going to have to be the ones to
 

help redact the information as provided in whatever
 

form or shape this actually takes, so we're going to
 

know who's behind each case. We're going to also be
 
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able to track other cases that have the same
 

similarity, the same issue, and they get revisited
 

back through the clause that says rework a dose
 

reconstruction. 


DR. NETON: I would like to just add a
 

proviso though, that we -- we would reserve the
 

right to evaluate those comments and respond to them
 

if we don't believe that they are correct. Merely
 

because a person states that the material could have
 

been fast solubility class may or may not be true, I
 

mean we need to evaluate that, and that would sort
 

of be more claimant friendly for, you know, kidney
 

or something like that; so, you know, we would look
 

at it and if there was credible evidence provided by
 

the review that we screwed up, of course we would
 

address that and fix it.
 

MR. MILLER: I just -- I hadn't heard that
 

before. The authorities I knew existed, but I
 

hadn't heard you actually state on the record that 


-- that when these Blind cases got brought to you
 

and you could go do that. That's great. That's
 

terrific. That's very -- that's a good answer.
 

MR. ELLIOTT: Hey, Richard, you could talk a
 

little bit more about the good things we're doing,
 

you know, get some of that on the public record too
 
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-- you know, when you force me to make comment on
 

the public record I'm going to give you an honest
 

response, but I'd appreciate hearing some things
 

from you about some of the good things we're doing,
 

some of the claimant favorable things we're doing.
 

MR. MILLER: As soon as we move pass the
 

initial Chapter 14, I can't wait. 


The -- the -- this is a, to the DOL
 

question. There were a number of policy issues that
 

got raised today regarding whether DOL, or NIOSH, or
 

perhaps even other choices are available as a
 

contracting authority. And I just sort of wanted to
 

float a couple of ideas on that area. I think one
 

of the concerns that was playing out, at least as I
 

sensed at the last Board meeting, was -- the
 

question of whether the Board was really comfortable
 

having NIOSH select, and other others have said it,
 

whether NIOSH should be selecting the audit
 

contractor for you all, so then there was a
 

discussion about how many Board members would
 

participate, who else -- how you would select the
 

auditor so it wasn't seen as NIOSH auditing itself,
 

in effect, and -- and -- or at least selecting its
 

auditor. And then it seemed to me that was sort of
 

one point of clearance, which, if it's resolved -- I
 
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don't know if it is or not -- but if it's resolved,
 

then it seems to me the question is: What are the
 

conflict issues that are raised by having it in
 

OCAS; what are the conflict issues that are raised
 

by having it, perhaps elsewhere in NIOSH, meaning
 

the contracting authority; or in CDC, or jumping
 

completely out of the agency, and in this case, into
 

DOL, and what are the advantages? And a couple of
 

things, at least, come to mind. I guess -- and it
 

has to do with how will it work in the real world if
 

you took it outside of either the NIOSH or CDC
 

world. One of the questions is: If you've got it 


-- if you've got DOL as your contracting entity -­

this is what I was having a hard time getting my
 

head around today -- if DOL is the contracting
 

entity and they say, "Say, we really want to do
 

these telephone interviews that NIOSH doesn't want
 

to do." Okay. It's an issue of disagreement about
 

the scope. How does -- how does that get resolved? 


I mean cause it's an agency now that has the
 

contracting, and it gets the appropriations too, so
 

they get the money first, and they also have -­

they're supposedly going to respond to what the
 

Board wants, although it's not clear what the legal
 

authority is that the Board has to drive what DOL
 
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does. That's not in a statute, so you'd have to
 

create some legal authority. But assuming that
 

legal authority existed, for the sake of this
 

hypothetical question, you know, how -- how would
 

those issues be resolved, which leads to another
 

sort of real-world question, which is -- and I don't
 

even know what the boundaries are that you've all
 

thought about is -- would the auditor have access
 

only to you and your records, this audit contractor,
 

or would they also have access to your contractor,
 

meaning ORAU -- you know, and -- and -- and
 

depending on what your answer is, or depending on
 

the terms and conditions of that, you all may find
 

yourself, you know, in this interesting situation
 

where, you know, you're going to have to start
 

resolving these interagency disagreements about how
 

to work this through. And so I just -- I wanted to
 

see some sort of real-world examples about how this
 

is going to -- is this really going to work
 

smoothly, I guess is the question.
 

DR. ZIEMER: Richard, I don't think any of
 

us have a good answer for you. We were raising
 

those kinds of questions in different forms as we
 

debated this -- this very issue. We indicated
 

earlier today that while there may be some pros of
 
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using DOL, there are also some cons, and vice-versa. 


I'm not sure the hypothetical things that you raise
 

here now are even answerable at this point to any of
 

us, unless Larry has prepared the answer, but -- but
 

I'm going to take those more as rhetorical
 

questions. I -­

MR. MILLER: Yeah.
 

DR. ZIEMER: You're raising issues that we
 

can think about as we -­

MR. MILLER: I'm raising those questions to
 

think about it would operationalize. (sic) And I
 

guess to lead to a second part, which is how long is
 

it going to take us to -- you all, NIOSH staff,
 

whomever, makes the decision or advice, how long is
 

it going to take you to figure this out? In other
 

words, do you have to go to your next Advisory Board
 

meeting in Knoxville, St. Louis, wherever, before
 

you decide who is even going to be the contracting
 

entity before you put the RFP on the street because
 

there's a lot -- the devils may be in the details
 

here, I don't know. 


DR. ZIEMER: Well, come back tomorrow and
 

find out.
 

MR. MILLER: Oh, you think you're going to
 

decide tomorrow?
 
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DR. ZIEMER: I would hope -- I would hope we
 

can make a decision by tomorrow, but in any event -­

MR. MILLER: Yeah.
 

DR. ZIEMER: -- you know, I clearly -- and
 

let me just say that I'd be a little nervous about 


-- we have a certain mandate under law and under the
 

Executive Memorandum in terms of the responsibility
 

of this Board and how it's set forth and so on. And
 

it's not clear to me at all that we could even, as I
 

said, legally move this procurement to another
 

agency, at least the way things are set up now.
 

MR. ELLIOTT: Let me talk to that because
 

that -- we don't believe there's any legal authority
 

issues here. It's one procurement, whether it's run
 

through a -- a HHS Procurement Office, or it's run
 

through a DOL Procurement Office. The Board advises
 

the Secretary of HHS. Whether it's NIOSH effecting
 

and awarding and administering the procurement, or
 

it's DOL, any issues that come up through the
 

deliberation of the Board in development of task
 

orders is going to be transparent to the public. 


The Board will report to the Secretary if they've
 

got problems with whoever is effecting, you know,
 

the -- the issue at hand for that given point. I
 

don't know what to say beyond that, I mean that's -­
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DR. ZIEMER: That answers your question then
 

on what the Department of Labor could impose or not
 

impose on the Board.
 

MR. MILLER: Well, you'd have to formalize
 

that, right, in some respect, wouldn't you?
 

MR. ELLIOTT: The Department of Labor is not
 

-- not -- all they would be doing is taking on the
 

administration of the contract. There's no -­

there's no necessity to have a legal authority or
 

formality about that.
 

MR. MILLER: Except that Dan takes direction
 

from this Board. Wouldn't they, I mean wouldn't you
 

all, if you come up with a task order and say do
 

this.
 

MR. ELLIOTT: They -- they're just
 

administering the procurement, the contract. That's
 

all they're doing. They don't -- you know, if the
 

Board comes up with a task order, the -- the only
 

bounds that would be on this would be the same for
 

DOL or NIOSH, and that's to stay within the FAR,
 

Federal Acquisitions Regulation. Okay. So if a
 

task order comes surfacing up through the Board that
 

steps out of bounds in that regard, then whoever
 

administers it in the government is going to say
 

whoa, you can't do that. 

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MR. MILLER: So if -- so I guess then the
 

question is: If the DOL is merely carrying out what
 

sounds to me to be a kind of a pure administrative
 

function, not quite administerial because it's
 

probably more deliverable than that, but not a whole
 

lot more, than an administerial function, what's the
 

big upside in terms of -- I mean what is the upside
 

of -- of -- of moving the DOL versus using either
 

some part of NIOSH or -- I mean I -- I -- I could
 

see where you don't want to have the people who are
 

-- who are administering dose -- who are overseeing
 

dose reconstruction also overseeing their own audit. 


I mean there's something intuitively reasonable
 

about that, but I mean you -- you can get -- get
 

around that pretty quickly, you know, just by how
 

you, you know, use your administrative boxes within
 

CDC. And -- and the only reason I'm posing it is
 

just because every time we look at another set of
 

interagency relationships, and I'm not talking about
 

the really tedious ones that you have to deal with,
 

but -- and -- and -- and -- and -- and -- and for
 

which we think you're doing a good job. Noted. But
 

what is the upside? I mean what is the real upside
 

because at the end of the day the Labor Department
 

has a set of interests in this thing.
 
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MR. ELLIOTT: Sure. Sure.
 

MR. MILLER: They are not completely
 

neutral. They need to go to court someday and
 

defend when somebody comes along that says we
 

contest; we don't like the way you did dose
 

reconstruction; we challenge your assumptions, or we
 

don't even like ICRP, you know, we want you to use
 

some other model, whatever it happens to be they
 

want to go to court over; at the end of the day,
 

right, they go roaring into court and DOL is going
 

to have something to hold up and say geez, you know,
 

this thing's been audited. Look at these smart
 

people on this Advisory Board, and look at this
 

smart auditor they brought in, and look at these
 

smart audit reports, and this thing is not hand
 

leading, this is like the real, you know, this is
 

the Real McCoy, so they need this audit function,
 

but do they need this audit function in such a way
 

that it's going to -- that it's their contracted
 

authority versus yours?
 

MR. ELLIOTT: I don't know if you were in
 

the room earlier when Pete Turcic and I were talking
 

to this point. The only advantage that it brings to
 

NIOSH/CDC/HHS is it removes this perceived conflict
 

to DOL, if DOL administers the contract. We -- you
 
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know, the only -- the only aspect of the
 

relationship if DOL run it that we talked about
 

earlier, Pete mentioned that we would probably need
 

a Memorandum of Understanding. Our relationship
 

with DOL has been exceptionally good over the course
 

of this -- this program's history, unlike that with
 

another agency that we've had. So, you know, we've
 

-- we've even talked about, you know, how quickly an
 

MOU could be put in place and all the principals in
 

both sides, both departments are -- are
 

knowledgeable of this and ready to that if that's
 

what it takes, so.
 

MR. MILLER: Okay. All right. I mean I
 

just -- it -- it sort of popped up. This is the
 

first time it was sort of discussed probably, and,
 

you know, at least from my perspective I just sort
 

of thought, you know, if you want to move it out,
 

you know, you can move it to another part of NIOSH,
 

I mean you don't have to move it all the way over to
 

DOL, you can move it over to another part of CDC. I
 

mean, you know, I wasn't quite sure the rationale
 

for that versus, or, you know -­

MR. ELLIOTT: Let me be clear.
 

MR. MILLER: -- OCAS and put it in -­

MR. ELLIOTT: NIOSH is NIOSH. Okay. I am
 
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NIOSH. I report -- I report to the Director of
 

NIOSH, so it's not OCAS. When we do a procurement,
 

it's done through NIOSH's Procurement Office.
 

MS. DiMUZIO: It's done by the CDC.
 

MR. MILLER: Right.
 

MR. ELLIOTT: Which is CDC's.
 

MR. MILLER: Right. That's the point, the
 

CDC. 


MR. ELLIOTT: So -- so if it's CDC's, it's
 

CDC's. It's all -- it's all in the semantics. If
 

you want to call it NIOSH; you want to call it OCAS;
 

you want to call it CDC -­

MR. MILLER: Okay. 


MR. ELLIOTT: -- we're all in the same boat.
 

MR. MILLER: Okay. All right. Thank you.
 

DR. ZIEMER: That concludes our session for
 

today. I'd like to ask, Cori, are there any
 

housekeeping informational items we need to pass
 

along this evening? I'm not aware of any.
 

MS. HOMER: I would suggest that if you have
 

anything requiring security, please remove it from
 

the room.
 

DR. ZIEMER: Okay. 


MS. HOMER: Laptops, any kind of equipment.
 

DR. ZIEMER: Okay. 

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MS. HOMER: Because I can't guarantee that
 

the room will be locked.
 

DR. ZIEMER: Okay. Thank you. So noted. 


We begin tomorrow morning at 8:00 a.m. with
 

the sort of casual half-hour, and the Board is
 

recessed.
 

(Whereupon, the above-entitled proceedings
 

were recessed at 5:05 o'clock p.m., to be reconvened
 

Thursday, February 6, 2003, at 8:00 o'clock a.m.)
 

o0o
 
_______________________________________

263 

 

 

C E R T I F I C A T E
 

STATE OF GEORGIA )
 

COUNTY OF FORSYTH )


 I, Debbie G. Williams, Certified Court Reporter in
 

and for the State of Georgia, do hereby certify that the
 

foregoing proceedings were taken down by me; that the
 

foregoing proceedings were reduced to print by me; that
 

the foregoing VOLUME I, consisting of pages 1 through 262
 

represent a true, correct and complete transcript of the
 

proceedings; that I am not a relative, employee, attorney
 

or counsel of any of the parties; that I am not a
 

relative or employee of attorney or counsel for any of
 

said parties; nor am I financially interested in the
 

outcome of the action.
 

This certification is expressly withdrawn and denied
 

upon the disassembly or photocopying of the foregoing
 

transcript of the proceedings or any part thereof,
 

including exhibits, unless said disassembly or
 

photocopying is done by the undersigned certified court
 

reporter, and the signature and original seal is attached
 

thereto.


 This, the 22nd day of February, 2003.
 

DEBBIE G. WILLIAMS
 

CERTIFIED COURT REPORTER, B-2167
 
 

264 

THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

PUBLIC HEALTH SERVICE
 

CENTERS FOR DISEASE CONTROL AND PREVENTION
 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
 

convenes the
 

ADVISORY BOARD ON
 

RADIATION AND WORKER HEALTH
 

VOLUME II
 

The transcript of the Meeting of the
 

Advisory Board on Radiation and Worker Health
 

before Debbie G. Williams, Certified Court
 

Reporter and Notary Public; commencing at 8:30
 

a.m., Thursday, February 6, 2003, at The
 

DoubleTree Guest Suites, 181 Church Street,
 

Charleston, South Carolina.
 

*************************************
 

DEBBIE G. WILLIAMS, CCR, CVR


CERTIFIED VERBATIM REPORTER
 

2515 Little John Court
 

Cumming, Georgia 30040
 

(770) 886-9814
 
265 

PARTICIPANTS
 

BOARD MEMBERS
 

CHAIR:
 

PAUL L. ZIEMER, Ph.D., Professor Emeritus


School of Health Sciences
 

Purdue University


West Lafayette, Indiana
 

EXECUTIVE SECRETARY:
 

LARRY J. ELLIOTT
 

Director, Office of Compensation Analysis and Support


National Institute for Occupational Safety and Health


Centers for Disease Control and Prevention
 

Cincinnati, Ohio
 

MEMBERSHIP:
 

HENRY A. ANDERSON, M.D.


Chief Medical Officer
 

Occupational and Environmental Health


Wisconsin Division of Public Health
 

Madison, Wisconsin
 

ANTONIO ANDRADE, Ph.D.


Group Leader/Manager


Radiation Protection Services Group


Los Alamos National Laboratory


Los Alamos, New Mexico
 

ROY LYNCH DeHART, M.D., M.P.H.


Director, The Vanderbilt Center for Occupational


and Environmental Medicine
 

Professor of Medicine
 

Nashville, Tennessee
 

RICHARD LEE ESPINOSA
 

Sheet Metal Workers Union Local #49
 

Johnson Controls
 

Los Alamos National Laboratory


Espanola, New Mexico
 

MICHAEL H. GIBSON, President


Paper, Allied-Industrial, Chemical, and Energy Union


Local 5-4200
 

Miamisburg, Ohio
 
266 

MARK A. GRIFFON, President


Creative Pollution Solutions, Inc.


Salem, New Hampshire
 

JAMES MALCOLM MELIUS, M.D., Dr.P.H.


Director, New York State Laborers' Health and Safety


Trust Fund
 

Albany, New York
 

WANDA I. MUNN, Senior Nuclear Engineer (Retired)


Richland, Washington
 

ROBERT W. PRESLEY, Special Projects Engineer


BWXT Y-12 National Security Complex


Oak Ridge, Tennessee
 

GENEVIEVE S. ROESSLER, Ph.D.


Radiation Consultant
 

Professor Emeritus
 

University of Florida


Elysian, Minnesota
 

SPEAKERS
 

STAFF
 

CORI HOMER, Committee Management Specialist, NIOSH
 

WRITER/EDITOR
 

TERESA ROBINSON
 
267 

I N D E X
 

VOLUME II
 

February 6, 2003
 

REGISTRATION AND WELCOME


 Dr. Paul Ziemer, Chair ................... Page 268
 

REVIEW AND APPROVAL OF DRAFT MINUTES
 

BOARD DISCUSSION/WORKING SESSION ............ Page 388


Draft Attachment A 


OF MEETING 10


 Dr. Paul Ziemer, Chair.................... Page 268
 

BOARD DISCUSSION/WORKING SESSION


Dose Review Process.......................... Page 277
 

BOARD WORK SCHEDULE ......................... Page 361
 

ADMINISTRATIVE HOUSEKEEPING.................. Page 377
 

ADJOURN PUBLIC SESSION ...................... Page 413
 
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268 

P R O C E E D I N G S


 8:30 a.m.
 

DR. ZIEMER: Good morning, everyone. We
 

want to also welcome Henry Anderson to our group
 

this morning. We're glad to have you here, Henry. 


We got all the good stuff done yesterday.
 

DR. ANDERSON: Yeah, that's what I figured.
 

DR. ZIEMER: We'll tell you about your
 

assignments a little later. 


I want to remind all of the Board members
 

and others who are here today to register today,
 

even if you registered yesterday, we ask you to
 

register each day, so please do that in the
 

registration book if you haven't already. 


Also, the members of the public who wish to
 

comment during the Public Comment Period, we ask you
 

to sign up for that. I do want to give members of
 

the public a kind of heads-up that it's quite
 

possible that we will complete our work schedule
 

earlier than the original Agenda shows, in which
 

case we would move the Public Comment Period up a
 

little bit toward closer to midday, so if you will
 

make note of that. I don't have a specific time at
 

this point because it's going to depend on how hard
 

and long I'm able to keep the Board working.
 
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269 

We're going to begin this morning with the
 

Minutes of the last Open Meeting, that is the
 

Meeting Number 10. That meeting was the January 7th
 

and 8th meeting. I'd ask the Board members to get
 

their copies of that, and what we will do on the
 

Minutes, I ask you that if you have typos and minor
 

grammatical changes, that you simply pass those
 

along to Cori separately. As we approve the Minutes
 

we want to take action on specific things that may
 

be conceptually or factually wrong, so when I ask
 

for corrections, or additions, or deletions, we'll
 

focus on those kinds of things. So let's -- let me
 

call attention first to the Executive Summary
 

section of the Minutes. I might say
 

parenthetically, I had an initial review myself of
 

these Minutes and I shortened the Executive Summary
 

by several pages. It was nearly as long as the
 

Meeting Minutes, and it still seems a little long to
 

me, but because there were a number of bullet points
 

that I ended up leaving in that I was going to
 

delete. I was planning to delete nearly all of the
 

bullet points and just let it stand, but I decided,
 

for example, to leave the Public Comment Summary,
 

all of those bullet points in, rather than simply
 

say we had a Public Comment Period, so the Executive
 
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Summary is a little longer than perhaps it should
 

be, but nonetheless, that's it. 


Let me ask if anyone has any corrections,
 

additions, or deletions for the Executive Summary? 


It's pages 1, slash, 8 to 8, slash, 8.
 

MR. NAMON: Dr. Ziemer, on page seven -­

DR. ZIEMER: You need to identify for the
 

court reporter.
 

MR. NAMON: Yes, David Namon, Department of
 

Health and Human Services. 


On page 7 under Board Housekeeping, the
 

description of the possible need for a conference
 

call on February 19th and 20th is not accurate, and
 

not the way it was actually said at the meeting, and
 

I would suggest that we delete everything after the
 

-- where it says February 19 or 20 to the end of
 

that sentence.
 

DR. ZIEMER: "The likely need for a
 

conference call on February 19 or 20, for two to
 

three hours to discuss SEC rulemaking to be issued
 

on" -- I'm sorry. What are you -- what are you
 

saying?
 

MR. NAMON: I'm saying that -- that
 

everything after the word "rulemaking" is -- is not
 

accurate, and is not what was said at the meeting. 

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271 

And so, obviously the rulemaking was not -- there
 

was not a rulemaking issued on January 20th. That's
 

also not what was said at the meeting that there
 

would be, so I would suggest that we would remove
 

everything in that phrase.
 

DR. ZIEMER: Okay. Let me make two comments
 

first. The fact that it didn't occur is immaterial
 

to the minutes.
 

MR. NAMON: Agreed.
 

DR. ZIEMER: So it's what was stated at the
 

meeting which you said was incorrect?
 

MR. NAMON: Right.
 

DR. ZIEMER: What was stated then? Because
 

this is based on what the recorder recorded.
 

MR. NAMON: What stated at the meeting was
 

that it was possible that something could be issued
 

during that time frame, I think during the month of
 

January. 


I think the clearest way to deal with it
 

would be to delete everything after the word
 

"rulemaking", if -- or to delete everything after
 

the number 20; but in any event, it was not -­

obviously nobody said, including you, Mr. Chairman,
 

nobody said that there would be something issued on
 

a particular date.
 
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272 

DR. ZIEMER: Oh, as opposed to an expected.
 

DR. MELIUS: I think what -­

DR. ZIEMER: It was the expectation that
 

somebody -- something would be issued on or about
 

that date.
 

DR. MELIUS: Well, if it were issued on
 

that, that was maybe the -- the week it might be
 

issued, in which case, then we needed to be able to
 

have our conference call within the 30-day period
 

that we needed it to complete the Board's review, so
 

the date came from an estimate of -- I'm trying to
 

figure out what was the correct timing for those
 

conference calls. And the particular dates were
 

discussed. I mean it is there, but I think what's
 

not accurate is the -- I don't think, Larry, or
 

whoever was speaking at that time said that it would
 

be issued on the 20th.
 

DR. ZIEMER: I have a -- Tony, you have a
 

possible solution. I think -- I think we want to
 

capture the idea of why we were going to have this
 

meeting, and it was based on an expectation; the
 

fact that it didn't occur is not a part of the
 

minutes, but we do want to correctly express what
 

did occur at the meeting.
 

DR. ANDRADE: Thank you. I do recall that
 
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the SEC rulemaking was, in fact, discussed, and we
 

talked about the possibility of the SEC Rule to be
 

issued on or about a date, so I would propose that
 

the solution is to simply include the word possibly
 

between "to" and "be" on that particular sentence. 


In other words, two to three hours to discuss the
 

SEC rulemaking -­

DR. ZIEMER: How about an expected SEC
 

rulemaking?
 

DR. ANDRADE: Okay. Discuss the expected
 

SEC rulemaking, possibly to be issued on January
 

20th. 


But I do recall that that was the essence of
 

our conversation.
 

DR. ZIEMER: Well, the expectation was that
 

we would be discussing the rulemaking at this
 

meeting and then finalize it.
 

DR. ANDRADE: Right.
 

DR. ZIEMER: Yes, go ahead.
 

MR. NAMON: I have the transcript in front
 

of me, and it was indicated that we were hoping that
 

something would be published during that week of the
 

20th, but again, no one suggested that a particular
 

date that it was expected. 


DR. ZIEMER: Based on that, let me suggest: 

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The expected SEC rulemaking that -- that possibly
 

would be published the week of January 20.
 

MS. ROESSLER: Or "if it is in January."
 

DR. ZIEMER: An expected SEC rulemaking if
 

it is issued the week of January 20.
 

MS. ROESSLER: Uh-huh (affirmative). 


DR. ZIEMER: Would that solve it?
 

DR. MELIUS: Yeah.
 

DR. ZIEMER: We're not trying to -­

DR. MELIUS: That's fine.
 

DR. ZIEMER: To discuss the expected SEC
 

rulemaking if it is issued on the week of January
 

20th. 


So that would capture what we did based on
 

some expectations without pinning down a date. Does
 

that fix it, I suppose. There's no question we
 

discussed it while we were doing the meetings. 


We're not trying to pin down NIOSH as having
 

committed to that.
 

MR. ELLIOTT: I'm even more gun shy to say
 

anything.
 

MR. NAMON: Now, when you get to the main
 

minutes there's a similar change necessary.
 

DR. ZIEMER: Oh, yeah. Hold on for that. 


Okay. Anything else on the Executive
 
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275 

Summary? Wanda.
 

MS. MUNN: I haven't seen the transcript,
 

but my memory of the meeting dates that we discussed
 

-- actually, what I wrote on my calendar was that
 

April 28th, 29th, was a potential, and we still,
 

that May 1st and 2nd were the probables. I -- I
 

don't know whether that's -- whether my notes are
 

incorrect. Of course, we're not going to get around
 

to discussing that until this afternoon, but I had
 

potential April 28th, 29th, and probable on May 1,
 

2.
 

DR. ZIEMER: Anyone else comment? I have
 

both blocked off without any change.
 

MR. DeHART: I believe that was for the
 

forthcoming meeting, the next meeting, not to be a
 

phone call.
 

DR. ZIEMER: Right. Right.
 

MS. MUNN: Yes, that's correct, but I'm
 

talking about the next meeting.
 

DR. ZIEMER: She's asking whether -- whether
 

we indicated a preference of one over the other.
 

MR. DeHART: The 28th and 29th I'm not
 

available.
 

MR. PRESLEY: My recollection on that was
 

that we marked them both, and Cori was supposed to
 
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276 

go back and see which one she was able to get a date
 

on.
 

DR. ZIEMER: Apparently, all of these were
 

indicated as being available to members of the
 

Board. I don't believe this says one or the other
 

is preferred at this point.
 

MS. MUNN: Okay. My notes may be wrong.
 

DR. ZIEMER: Okay. Thank you. Any other
 

corrections or additions on the Executive Summary? 


Now, let's go to the main Minutes, and we
 

can handle the same change that we just noted on
 

Board Housekeeping.
 

David, what page are we looking at that?
 

MR. NAMON: It's page 21. It's the second
 

paragraph under Board Housekeeping. I think if you
 

changed the word "will" to "may".
 

DR. ZIEMER: Yes. So, "will be" to "may be
 

issued", a conference call may be needed. That will
 

solve that. Thank you. Without an objection, we'll
 

make that change.
 

Other comments, other corrections, or
 

additions?
 

There's no additional corrections or
 

additions. The Chair will accept a Motion to
 

Approve the Executive Summary and the Minutes as
 
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noted with the changes.
 

MR. PRESLEY: So moved.
 

DR. ZIEMER: Seconded?
 

MR. DeHART: Second.
 

DR. ZIEMER: Further discussion?
 

All in favor, aye.
 

(Ayes respond.)
 

DR. ZIEMER: Any opposed, no.
 

(No responses.)
 

DR. ZIEMER: Abstentions?
 

(No responses.)
 

DR. ZIEMER: The Motion carries, the Minutes
 

then are approved with those changes as made.
 

Now, let me give you kind of an outline of
 

where I see us headed on our Work Session here. 


There's several items that we need to address. One
 

of those will be the decision as to who will be the
 

-- let me just say the agency that will let the
 

contract on behalf of the Board. And we currently
 

have two options that we're considering; one is the
 

Department of Labor, the other is NIOSH or CDC; we
 

view that as one entity, NIOSH/CDC. We don't have
 

to decide that at the front end here, but I would
 

like us to come to closure on that if possible
 

today, so that we can proceed and have whatever time
 
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278 

we gain by moving forward achieved. So that
 

decision is before us.
 

We also need to come to some sort of
 

agreement on exactly what will be covered in
 

procedures for the review process; that is, the
 

review of completed dose reconstructions, the audit
 

process, if you will. 


Now, I'm going to propose certain things
 

here as we proceed. Number one, I have some
 

overheads or slides where I hope I've captured what
 

we kind of delineated yesterday. This will help us
 

and maybe also help the recorders to figure out what
 

it was we agreed to.
 

I also have a kind of a strawman procedure
 

to give us some feel for what a procedure might look
 

like. But in preparing the strawman -- this is just
 

something for us to shoot at -- in preparing this,
 

it became pretty clear to me that to really do the
 

procedures, I don't think we can sit here in Board
 

session and develop that; in fact, it seems to me
 

that we are going to have to do a mockup; we're
 

going to have a workgroup maybe go to NIOSH and
 

actually go through some dummy reviews -- dummy
 

reviews might not be a good word for it, but reviews
 

for dummies, maybe that's what it is -- maybe one or
 
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two of each kind and start stepping through it and
 

say okay, what do we do first. We look at the site
 

profile; is it complete, and start -- sit there and
 

really work through the procedures. We may also
 

need to take a look at some of NIOSH's and ORAU's
 

procedures to see how they're going about looking at
 

these things. I mean step wise because we can't -­

I don't think we can proceed beyond that today, but
 

-- but we can at least identify what the complements
 

of those procedures are with these, so that's what I
 

propose we do today, and make sure we're all on the
 

same page in terms of sort of the overall scheme of
 

things; what needs to be covered, maybe what does -­

what do the final products look like, and what would
 

be the content, what procedures we need to cover. 


But I'm not sure we can go beyond that today, and we
 

may need a workgroup then to follow up on it.
 

Okay. So we have those two things relating
 

to the completed dose reconstruction review process.
 

We also have the issue of the special
 

exposure approval legislation, which we know will
 

not be available January 20th, or even the week of
 

January 20th, but may -- but may be published
 

sometime in the near future. 


Now, our next meeting, if it's the end of
 
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April or in to May is nearly three months away; all
 

of February, all of March, most of April, and if
 

that hits the street before April 1st, then our next
 

meeting will be too late to react to that proposed
 

rulemaking. So I think we will probably need to
 

identify another meeting time before then. So when
 

we get to the Board work schedule later this
 

morning, that will be one of the items we'll need to
 

address. And there is some possibility we may have
 

something close to an estimate of when that might -­

MR. ELLIOTT: We're hoping to hear something
 

this morning so that we can inform the Board to help
 

make the schedule happen. 


DR. MELIUS: 2003. Pin it down. We've got
 

to pin it down.
 

DR. ZIEMER: In any event, that's what we
 

have before us, I think, today. And in thinking
 

about that and perhaps the extent to which we can do
 

some of that work, it occurred to me last night that
 

we might very well finish by midday, depending on
 

how things go.
 

Now, let me just pause, and if anyone wants
 

to react to anything I said, or comments, or shall
 

we proceed? I'm open to -- always open to better
 

ideas. 

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Henry, you can't move to dismiss now.
 

MR. ELLIOTT: Two things I would suggest
 

that you consider and you perhaps want to put these
 

into the future, but this concept of having a task
 

order prepared so that it's on the table so that, I
 

mean when the contract is awarded I don't think you
 

want to have a delay of developing a task order; you
 

want to be able to present that within the first
 

week of the award to get these folks started. The
 

second thing that I think you should consider is
 

something I mentioned to Mark yesterday afternoon,
 

and I think Richard Miller also brought it up in his
 

public comment, is what's -- what's your product at
 

the end of this, you know, what are you going to
 

deliver to the Secretary. I think you need to think
 

a little bit about that and through that. I don't
 

think you're going to want to provide a
 

recommendation on every review that you do, every
 

dose reconstruction review that you do, but I think
 

you need to figure out, you know, what's the
 

appropriate communication to make. 


DR. ZIEMER: Right. And in fact, that's the
 

nature of one of the key questions I will ask this
 

morning as we proceed.
 

Other general comments before we move on?
 
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Okay. Let's see, do I need to work that
 

clicker from the front or can I work it from here?
 

DR. NETON: We'll have to check and see. I
 

guess so, maybe it will work from there. Why don't
 

you just try it once and see if it will move
 

forward?
 

DR. ZIEMER: Okay. 


So this is what we -- this is what we were
 

discussing yesterday, and what I've done here is
 

broken this into several points that we were talking
 

about. The first was that we said we had to have -­

had to identify the available cases to review. This
 

is not necessarily just those completed, but as we
 

look forward, so I've -- all I'm doing here is
 

raising some questions, and I want to make sure in
 

these questions that we've covered content wise what
 

it is we're trying to do. For example, who should
 

do this, is it the full Board, is it a Workgroup, is
 

it a Subcommittee, when should it be done, and
 

what's the nature of the product; that is, whoever
 

identifies these cases, do they come back to the
 

Board with a report and say these are the cases we
 

believe should be reviewed, or do they just proceed? 


Are these the right questions; are there additional
 

questions; and to what extent can we answer these
 
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right now. 


I just would like to capture this if we can
 

and get the Board's ideas, and then we'll move on to
 

the next item, which is the case selection process. 


Okay. Again, we talked about each of these a little
 

bit yesterday, so I'm feeding back to you what we
 

talked about. We talked about some of these
 

questions yesterday, but I want to make sure we're
 

on the same page on it, so.
 

Okay. Roy.
 

MR. DeHART: When we're talking about who
 

should do it, certainly at the initial stage I think
 

the Board as a whole needs to be involved, but that
 

doesn't mean it needs to be the Board going through. 


A workgroup could come out with suggestions using
 

the model we had on the percentage that we had
 

developed before. So I would suggest that we have a
 

workgroup that would go through the available 60,
 

70, 80, whatever it happens to be at the time, and
 

make the selections against a matrix, and then
 

present those to the Board for final approval, so
 

the Board would know exactly what the process is.
 

DR. ZIEMER: Okay. Let's get some other
 

feedback. Jim.
 

DR. MELIUS: Yeah, I -- I think we need a
 
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workgroup to do this, but I think it's got to be
 

sort of a step-wise process throughout this, and
 

maybe it's more than one workgroup or different
 

workgroups, but as I understand what's required by
 

the FACA regulations is that we -- the Board would
 

have to approve a lot of the steps along the way. 


So I would see it as a workgroup that would put
 

together, you know, do some of the -- the work,
 

looking as they develop new forms, whatever would be
 

involved, then would come back to the Board probably
 

at each meeting with a certain, you know, things for
 

approval, and is this going to apply to -- some of
 

this would be the task order development because
 

that's really an important part of this process, and
 

I think actually the first thing that we should try
 

to work out, and maybe it's having the workgroup do
 

it, is a schedule for this step wise because we have
 

a number of issues that are going to need some time
 

to work on. 


Larry, you've already mentioned the idea
 

that we need to get these task orders ready at the 


-- hopefully at the time that the -- or around the
 

time that the contract is awarded. We also have
 

this OMB question hanging out there about the -- the
 

interview issue. And so I think the sooner we can
 
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get that prepared, the better in terms of getting
 

approval for that. So I think the only way it can
 

be done is through a workgroup, but a workgroup that
 

serves discrete functions or tasks that would then
 

report back to the Board at each meeting, and then
 

we would go on and then do something else at the
 

next meeting and so forth.
 

DR. ZIEMER: And keep in mind, we can always
 

change the process at any time, but I've kind of
 

looked at this as the first time through, and, you
 

know, once we've sort of developed the procedures
 

and get -- get the process rolling, we may want to
 

alter how it's done, but I'm really looking at
 

getting under way, and I've heard a couple of
 

suggestions about the workgroup.
 

Henry?
 

DR. ANDERSON: Yeah, I think a workgroup,
 

but it would seem to me if -- if this is basically
 

an algorithm, I mean we've said which cases we want
 

to review, then basically it's you pick a cutoff
 

date and then everything before that you then
 

classify them into our various categories, and then
 

you'd have a random, you know, selection process. 


So it would seem to me if you pick various dates,
 

whatever's, you know, prior to that date would be
 
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eligible, and then, you know, each time we meet
 

perhaps we could have -- or you could set the date
 

of cutoff a certain number of weeks or whatever
 

prior or completed cases, however we're going to do
 

it, prior to the next meeting, so that at the
 

meeting we could say the process was done, and here
 

are 6, 10, 100 cases ready to go, so that it would
 

it be a -- once we decide how it's going to be done
 

it would be -- at least the selection process would
 

be more automatic than having a group necessarily
 

have to get together to review that data, and then
 

say yes, do the selection process. I mean I -- for
 

the early on I think the more we can kind of
 

automate it and it's transparent because we've set
 

out the criteria for how to do it, it then just has
 

to be, you know, so that the records actually are
 

completed and available and all back wherever they
 

need to be for the review to start, and that's kind
 

of a NIOSH, you don't want to set a date so that
 

we'll have some cases come in that aren't yet really
 

fully completed. So that's how I would do it and if
 

-- if it's setting up those, translating our
 

guidelines as we've put together into an algorithm,
 

that certainly could be done by a workgroup, but I
 

would not want to have a workgroup have to meet
 
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every time to say here they are, and then shuffle
 

them into groups. I think if we select the criteria
 

that are already in NIOSH's data base, that can all
 

be done electronically.
 

DR. ZIEMER: Other comments? Wanda.
 

MS. MUNN: Yes. I think that Jim and Henry
 

both have captured most of my thinking, which very
 

clearly indicates in my mind that we need two
 

separate workgroups approaching this initial issue;
 

one of them to identify how the NIOSH matrix is
 

going to be able to present the information to us,
 

and identify how we can use that matrix to resolve
 

our issues of percentages in terms of how we're
 

going to cross-cut the reviews that we do; and
 

another to actually put together the kind of
 

checklist that we were talking about to work with
 

NIOSH to see what their checklist covers; is it
 

adequate for our purposes.
 

DR. ZIEMER: Right. I don't want to get you
 

ahead of the headlights here. Those are separate
 

issues. Right now it's the issue of saying what's
 

out there. NIOSH will have completed a certain
 

number of cases. And we talked about some extremes,
 

suppose they were all Savannah River cases, then
 

what do we do.
 
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MS. MUNN: Yeah.
 

DR. ZIEMER: Or do we say okay, we're going
 

to sample a certain amount of those and then wait
 

for a certain number of these. So this process, the
 

identification of available cases, is kind of
 

looking ahead at -- at what NIOSH is doing and
 

saying what parts of these are we going to look at. 


DR. ANDERSON: Yeah.
 

DR. ZIEMER: That's all it is, and so we'll
 

say who's going to do that; how soon do we do that;
 

do we have to do that right away, like within the
 

next month, or can we wait till, you know, after the
 

contract is let. I'm trying to pin this down
 

because a lot of what we've done so for is fuzzy. 


We're going to do this, but who is going to do it,
 

and when are they going to do it, and what is it
 

they are going to do. That's sort of what we're
 

asking here. And that's what I would like to get
 

the Board -- and I don't know the answer to those
 

things; it's hard enough to know the questions to
 

ask, let alone the answers, so there may be some
 

other questions. And then what is this group, are
 

they going to come back to the Board and say okay,
 

we have a certain number of cases available from
 

here, here, and here, we're going to -- or what. 

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So Wanda, and then Tony.
 

MS. MUNN: So what I'm suggesting is that we
 

form a workgroup immediately to go sit down with
 

NIOSH and do essentially three things: Identify
 

what their matrix is going to cover; identify what
 

they have now; and then bring back to this Board a
 

suggestion as to how we will proceed down the line
 

because obviously, it's anticipated that the number
 

of cases are going to ramp up quickly. And since
 

that's the case, then our first -- first set of
 

cases may not really and truly have much to do with
 

what we're going to do long term. 


DR. ZIEMER: Okay. Thank you. Tony.
 

DR. ANDRADE: Wanda articulated a bit of
 

what I was going to suggest. I also believe that we
 

should form a workgroup, a representative workgroup
 

of this body, in other words, representing all view
 

points, that will come up with a draft of selection
 

criteria, a schedule for -- or a draft of number
 

one, selection criteria; number two is a draft set
 

of task orders; and number three is a draft
 

schedule. And I think that working from the
 

products that Mark has put together, the draft
 

schedule may not be all that tough. Who should do
 

it, and if we can appoint a working group, and I
 
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would suggest that we refrain from appointing
 

multiple working groups and that we keep maximum
 

flexibility by allowing, as time goes on, people to
 

rotate in and out such that those folks with time
 

available during a particular period of time can
 

continue to work. When should it be done? I think
 

the first report back on those specific products
 

that I mentioned should be available by the next
 

meeting, so the workgroup should be meeting in
 

between time. And the nature -- I've already
 

mentioned what the products would be here.
 

DR. ZIEMER: Very good. And we'll -- we'll
 

sort of keep those suggestions on hold until we hear
 

from everybody, and then when we formalize anything,
 

we can. And you weren't making a specific motion,
 

right then?
 

DR. ANDRADE: (Shakes head negatively.) 


DR. ZIEMER: Okay. Mark.
 

MR. GRIFFON: I actually agree with most of
 

what's been said. Building on what Wanda and Tony
 

said, I guess I, when we talked about this
 

yesterday, and how I formulated this in my head is
 

that really the selection criteria I think should be
 

developed first. And then the -- when we look at
 

the -- and I know I brought this issue up yesterday,
 
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so it's my issue, but when we look at the cases, I
 

think the cases and how they meet -- looking at our
 

selection criteria and looking at what's available,
 

that's going to build our schedule. That's going to
 

help us to build a schedule going forward and that's
 

sort of how I conceptualized this, but I -- I agree
 

also with what Tony said, that the, you know, the
 

selection criteria, the review of the available
 

cases, and building the schedule, along with the
 

task orders, procedures, and some kind of draft
 

format for the final report form should be developed
 

by some sort of working group, and, you know, the
 

structure of that right now I think is up for grabs.
 

DR. ZIEMER: Other comments? Robert.
 

MR. PRESLEY: Can we not come up with a
 

simple formula? We're going to do 150 of these a
 

year, is that correct? That comes out to
 

approximately 12 a month. Can we not come up with
 

some type of a simple formula that we can give HHS
 

and say okay, you know, we want 12. Now, where
 

those 12 lie, it may be 12 out of 50, it may be 12
 

out of 250. We ought to be able to come up with
 

some type of formula that you pick -- this month you
 

pick 1, 6, 8, and 10; next month you pick 30, 40,
 

and 50; and then we do the checking on whether we
 
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want to do a Blind out of those 12, or what we want
 

to do. And if it gets to where that one month all
 

of them are Savannah River, then -- then the next
 

month we tell whoever it is that we -- the next
 

month, you know, we've done Savannah River, we want
 

some different ones.
 

DR. ZIEMER: Larry.
 

MR. ELLIOTT: Those of you who were on the
 

workgroup that Mark headed up, I think -- and I
 

think several others may have seen our tracking
 

system, so you know what it's like; you know we can
 

query it. What I want to take exception to here is
 

that I've heard a couple of people comment that give
 

this to HHS, have the matrix, you know, tell, have
 

them select. We're not going to select, okay. I'm
 

going to tell you that right now. You guys are
 

going to have to select. You can come in, we will
 

set you up in front of the screen, you're going to
 

do the tracking, you're going to do the inquiry
 

there, and then you guys need to select.
 

MR. GRIFFON: Yeah, and I think, Bob, I
 

agree with you. I just -- in that, the example you
 

just gave with the Savannah River, I mean that's my
 

idea of having the selection sought ahead of time so
 

that we know, okay, over the year we expect these
 
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cases to come through at some point. Month by month
 

we start filling in those boxes and we see, okay,
 

we've completed all of our Savannah River
 

requirements, we've got to find cases in these other
 

categories, and we -- and we track it as we go on,
 

so, you know, that's consistent with what I think
 

we've been talking about.
 

DR. ZIEMER: Tony.
 

DR. ANDRADE: I just wanted to mention that
 

clearly we can't anticipate any -- any or all of the
 

problems we may have in finding cases that meet our
 

criteria. That's why I wanted to emphasize -- at
 

least at this point in time that's why I wanted to
 

emphasize the word "draft". This working group
 

should come back with a draft of selection criteria;
 

a draft of a procedure on how to go about working
 

with those cases, a draft task order list, and 


schedule, because as we go along we may dearly want
 

to address one issue or one particular type of
 

cancer, or something like that; however, the cases
 

may just not be available. So I'd say let's give
 

ourselves maximum flexibility, understand that this
 

is going to be a living sort of piece of work, if
 

you will, and that we will only really begin to be
 

able to focus on all of the issues that this Board
 
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is interested in as time goes on when there are
 

several cases available that -- that are of interest
 

to us.
 

DR. ZIEMER: It appears so far that there is
 

a pretty strong sentiment to having a working group
 

do this task of identification of available cases;
 

that it probably should be done fairly soon; and the
 

answer to the third question will depend on what
 

they find, but they would come back to the Board
 

presumably, at least the product will be some sort
 

of report back to the Board.
 

Is that all fair so far? I'm not trying to
 

lock us into anything, but we need to keep that
 

coming back in mind. 


Let's go on to the next item, which is the
 

Case Selection Process. And here again, these are
 

items that you all identified yesterday: Case
 

Selection Process; what's the process. We've kind
 

of answered some of this already. Who should do it? 


It already sounds like that's the working group, at
 

least to start with. When should that be done? 


That's probably locked in with -- or linked in, at
 

least, with the first item, if I am fairly
 

summarizing what's already been said. 


I think the third bullet is fairly obvious,
 
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we agree that the Board is going to need to approve
 

whatever is done by the workgroup. 


What's the nature of the product here. And
 

I'm not sure what form this ends up taking. It's
 

clear that we're not asking NIOSH to do the
 

selection, but we are asking for availability of the
 

case information. Now, I'm going to ask Larry a
 

question, so I'm going to pause just a minute.
 

DR. MELIUS: If I may comment. It wasn't
 

clear to me yesterday, and I think we're going to
 

need to get it clarified, this whole issue of the
 

Board having to approve sort of every step. And at
 

least based on my recollection of the discussions
 

yesterday, was there how we do the -- for the Board
 

to do the case selection, you know, I mean can we
 

have a workgroup do that, the actual case selection? 


Is that -- can we -- I think that it would make more
 

sense if we would approve the procedure for the
 

workgroup -­

DR. ZIEMER: I think that was the
 

understanding that we would say that the
 

recommendation might be that we will review a
 

certain number of cases of this type, and this type,
 

and this type, not that it's this person, this
 

person, and this person. And requesting the Board 

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-- request by the Board to NIOSH/ORAU to provide the
 

case files with certain characteristics, I'm not
 

sure what that means except in -- and I'm not sure
 

that you know what that means yet in terms of the
 

extent to which the identification of the individual
 

claims has to be done. So we would need to work
 

with NIOSH and ORAU on this in terms of privacy
 

issues because in principle we are trying to review
 

this process independent of who the claimant is;
 

obviously, you would know from the site from which
 

the claimant came because we would still want to
 

make sure that we don't have conflicts of interest
 

in the review process. But those issues remain, so
 

I'm not sure what we mean exactly by requesting this
 

of NIOSH. Clearly, we're not going to ask you to
 

pick the cases.
 

MS. MUNN: No.
 

DR. ZIEMER: But to make available
 

something, a product that can be reviewed in
 

whatever form. So comments on this.
 

DR. ANDRADE: Again, to maintain
 

flexibility, we may have selection criteria that
 

might -- that if we're hard and fast on them we may
 

not be able to meet them the first or second time
 

through; therefore, we, the working group can come
 
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up with a selection criteria. It can also come up
 

with the cases, given what NIOSH tells us -- yeah,
 

NIOSH tells us is available, and we can work on one
 

criteria, rather than another. 


I envision this working group, again, if we
 

have rotating membership, to provide different
 

products at different periods of time. For example,
 

if we commission a working group today, then I
 

believe that the first product, if you will, will be
 

nothing more than administrative procedures, as Jim
 

alluded to, okay. And those can be reviewed by the
 

Board during our next meeting; however, once the
 

contract is let, then the product, the nature of the
 

product is going to change dramatically. What I
 

would envision is general comments on how well the
 

Associated Universities is doing their job, and
 

also, perhaps findings, if any, on -- or questions
 

that may come up about how they are doing dose
 

reconstruction, whether they might pick out a couple
 

of areas that we might want -- we might be
 

interested in reviewing. So I think that that is
 

the direction in which the type of product will go
 

as time goes on, but we should give the working
 

group -- again, if it is a representative working
 

group, representative of view points across the
 
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Board -- as much flexibility to come up with the
 

cases, the selection criteria, maybe change control
 

processing insofar as changing the -- the criteria,
 

the selection criteria, depending on what is
 

available from NIOSH. So I think -- I think that
 

pretty much sums up the -- the way I feel that we
 

can get our arms around this fuzzy issue.
 

DR. ZIEMER: Thank you. Jim.
 

DR. MELIUS: One thing that we talked about
 

yesterday that I think will be important for the
 

workgroup early on is we're going to need to be able
 

to project the number of cases that will be
 

available over time. If we set up selection
 

criteria that are very specific, we may -- we could
 

easily end up with a situation where nothing would
 

be, those kinds of cases wouldn't be available for
 

five years or something, I mean, you know, something
 

sort of like that, and so I think we need to have a
 

feel for what will be the schedule of case -­

availability of cases, given the criteria and how
 

that can sort of fit into this process also.
 

DR. ZIEMER: And clearly we would need to
 

work with NIOSH and ORAU on that.
 

MR. GRIFFON: Yeah, and Jim, I think that's
 

consistent with what I said. The only thing I
 
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didn't want to see happen is that the availability
 

of cases drive the selection criteria. I think we
 

should, you know, think of that.
 

DR. MELIUS: Drive the schedule.
 

MR. GRIFFON: Drive the schedule, right.
 

DR. ZIEMER: Roy DeHart.
 

MR. DeHART: What we have really discussed,
 

I think, for the working group was working
 

initially, was a matrix. And a matrix can be filled
 

in at any time, so all you do is whatever you have
 

available that you fill -- put the squares where you
 

need to, and over time you fill them in.
 

MR. GRIFFON: Well, I think Jim's point is
 

that we don't want the matrix to be empty for the
 

first three years, right?
 

DR. MELIUS: Yeah.
 

DR. ZIEMER: Do you want to move on to the
 

next item at this point? And if I could summarize,
 

it appears that this work could be done in
 

conjunction with the other, that is the same
 

workgroup initially address these issues together.
 

Okay. 


Henry?
 

DR. ANDERSON: Yes, since we -- since
 

there's a considerable backlog now of cases that are
 
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in the system I guess the question would be to
 

NIOSH, what is the -- you know, are they going
 

through the cases in numeric order, the first-in,
 

first-out -­

MS. MUNN: Yes.
 

DR. ANDERSON: -- or how they're doing it
 

because it could be that if we set up some criteria,
 

if it isn't first-in, first-out, then they could, in
 

fact, over a year set up their review schedule that
 

would be -- would assure that some of the cases were
 

interested and go through the system. Now, that is
 

innately unfair -- unfair perhaps, but that's 


what -­

DR. ZIEMER: We heard yesterday that some of
 

the -­

DR. ANDERSON: First-in, first-out.
 

DR. ZIEMER: -- first-ins are still waiting,
 

yeah, in the long queue because of unavailability so
 

far of the -- or lack of information.
 

DR. ANDERSON: Yeah, I understand, but if
 

it's first-in, first-out, then we ought to know -­

we ought to know where they're coming, you know, to
 

be able to look at them.
 

MR. ELLIOTT: We are working first-come,
 

first-served, but that doesn't mean that you reap
 
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the fruit of that in those -- in the sequence.
 

DR. ANDERSON: Yeah, I understand. Yeah.
 

MR. ELLIOTT: So, for example, on, you know,
 

Bethlehem Steel site profile may knock out 300
 

claims for Bethlehem Steel in one fell swoop, but
 

those 300 claims, you know, there's probably a few
 

of them were in the 1,000, and, you know, the next,
 

they just sprinkle across, you know, in sequence. 


DR. ANDERSON: Right. Yeah.
 

MR. ELLIOTT: And so it's very hard for us
 

to predict when a particular claim in sequence is
 

going to come to final closure, so.
 

DR. MELIUS: And I think there's also a
 

potential problem in that some of the more difficult
 

-- some of the cases for which it's more difficult
 

to find information, to get adequate information,
 

are going to back up in the queue, and wait for a
 

site profile information, and that in some ways
 

could bias the selection process if we, when we pick
 

from the first 1,000 or whatever the number would
 

be, so I think there's some details that really have
 

to be looked into to make sure there's a fair
 

selection of cases.
 

DR. ZIEMER: Mark.
 

MR. GRIFFON: Yeah, and that was my point
 
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about -- about not letting the availability of cases
 

drive the selection criteria because I think that,
 

you know, some of those more difficult cases are
 

going to be the ones we're more interested in
 

reviewing also, so.
 

DR. ZIEMER: A good point. 


The third item we talked about was the
 

actual procedure for the selection of -- this is the
 

process, but the actual procedure for the selection
 

of cases. You see I'm asking some of the same
 

questions here. And they start to overlap,
 

obviously, but I've separated them out. I think it
 

appears now, based on the discussion, that some of
 

these answers are rhetoric, again, working group,
 

and we need to get underway with this. Keep in mind
 

that the actual procedure is different from the
 

process. The procedure is -- well, look at the end
 

there: What does a procedure look like? I've asked
 

that question. What does the selection procedure
 

look like? And if -- if we move toward having a
 

workgroup work on these things, then we would charge
 

them with doing that, tell us what -- and come back
 

to the Board and show us. That's not something I
 

think we can do here. In fact -- well, we'll get to
 

it in a moment. Let me solicit any other comments
 
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on this. This is the procedure for selection of
 

cases. It includes like you just mentioned, Mark,
 

what about the difficult cases which are down the
 

road; how do we assure that our procedure is
 

cognizant of those, so that as we instruct in the
 

selection of the cases that we allow for that, how
 

do we take care of this matrix, so.
 

Any other input on this item? Again, these
 

topics are all ones that were brought up by the
 

Board yesterday. I just want to make sure we're on
 

the same page as we go forward.
 

We're okay? Okay, let's move on.
 

Procedures for the review of the cases. 


This is having done the selection, when we actually
 

get cases to review. We need a review procedure,
 

and this question: Who is going to develop the
 

procedure, when should that be done, does the full
 

Board approve the procedure, and what would that
 

look like?
 

After asking those questions I thought about
 

this further, and have bounced this idea off a
 

couple of people this morning. It seems to me that
 

to answer this, what would a procedure look like, we
 

need to do one or two, or more, mock -- I call them
 

mock reviews, and actually have maybe it's the same
 
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workgroup sit down with some cases and start through
 

what would look like a, say a Basic Review. Now,
 

the first time through there's no procedures to even
 

do this. And you have to sit there and say okay,
 

what is the first thing we do, you know, do we ask
 

is the site profile adequate, or maybe step one is: 


Is there a site profile? Is it adequate? So you
 

start looking at procedures, but it seemed to me
 

that we're going to have to have a group hammer this
 

through and develop the procedures. And maybe look
 

at NIOSH procedures as to how they do a review,
 

their own, you know, the dose reconstruction; maybe
 

look at ORAU's, and gain some clues as to what it is
 

that needs to be done if you're reviewing. I think
 

of it as an auditor. An auditor uses some of the
 

same procedures in auditing as the accountants use
 

in accounting, they have to go through some similar
 

steps. 


Now, Tony.
 

DR. ANDRADE: In my mind I really see this
 

as kind of Phase II of the working group's charter,
 

if you will. Once we have established -­

DR. ZIEMER: So that has to do with when it
 

should be done, then?
 

DR. ANDRADE: No. 

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DR. ZIEMER: No?
 

DR. ANDRADE: But really this should be put
 

in the context of what is the product that we
 

eventually want from the contractor on board. Okay. 


I really believe that that is what drives -- what
 

would drive this kind of procedure.
 

DR. ZIEMER: Uh-huh (affirmative). Because
 

the last question, there may be a report on an
 

individual review, but what you do with all of those
 

reports -­

DR. ANDRADE: Right.
 

DR. ZIEMER: -- and compiling them into an
 

overall.
 

DR. ANDRADE: Exactly. And so I think that
 

this would be the work of the working group. It
 

could be a whole new set of members, it could be
 

some members that continue on, but this would be the
 

working group after we've met the next time to look
 

at the administrative part of selecting cases, case
 

availability, case number projection, and that sort
 

of thing. Then the working group would go on to
 

define the work to be done in these particular
 

arenas, and which is basically a task order. And I
 

have -- my own personal gut feeling is that it
 

would be driven very much by what is listed in the
 
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Basic, Advanced, and Blind Review steps that -- that
 

have already been deliberated to a certain extent.
 

DR. ZIEMER: Roy.
 

MR. DeHART: Actually, what we'll be doing
 

is primarily overlooking our contractor to assure
 

that they're doing what we're wanting, so in fact,
 

much of this may be feeding back into the task order
 

issues, as well as the basic contract that we're
 

just about ready to approve to go on the street.
 

DR. ZIEMER: Yes, but I want to make sure,
 

at this point I think it's useful for us to think of
 

our contractor in a sense part of us. Let's keep -­

we're not reviewing our contractor at this point. 


Our contractor is helping us do this review, so
 

let's -- it seems to me it might be helpful for us
 

to think of this in terms of suppose we were doing
 

this with no contractor, we're just doing it, it's
 

us. We really aren't having a contractor help us do
 

some tasks that we can't otherwise do either for
 

lack of time, or in some cases, lack of ability. I
 

-- and I say that in a nice way. We are not dose
 

reconstructionists, okay.
 

I think Jim was next, and then Mark.
 

DR. MELIUS: Yeah. Just to follow up on
 

that point. I think that this is going to be part
 
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of developing the task order. We're going to need
 

to have this done before we can do a task order, and
 

I think it needs to start relatively soon because
 

given the schedule that came out, given this OMB
 

issue that will be part of some of these reviews,
 

that we need to get this process underway relatively
 

rapid, and I don't think we can wait for this part,
 

for example, until after the April meeting. I don't
 

think that's what Tony was suggesting, but I don't
 

think we should do it too sequentially because I
 

think if we can get some of this started because if
 

-- if not, we're going to back up the whole process.
 

DR. ZIEMER: Mark.
 

MR. GRIFFON: That echoes my concern. I
 

mean I think it's -- I think in developing the
 

procedures I think our task order is going to be
 

more fleshed out, it's going to be kind of a
 

parallel process. And also just -- I was also maybe
 

worried about the sequential because I think either
 

we can put a lot of pressure on the Board to meet
 

sooner again to review these things step wise, and
 

that might, like Jim said, slow down things. We
 

need to get these things rolling.
 

DR. ZIEMER: Gen.
 

MS. ROESSLER: And along with that, I think
 
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that this workgroup needs to, whether it's a mock
 

review or whatever it is, needs to go to NIOSH,
 

needs to work with those people, needs to see what
 

they're doing because otherwise, it's sort of like
 

working in a vacuum; you really don't know what
 

their process is until you actually see it.
 

DR. ZIEMER: Gen, I certainly, in my mind
 

when we were talking about developing these
 

procedures, in my mind the working group has to be
 

there in Cincinnati and -- and I think that's what
 

you're suggesting. And maybe have some sample cases
 

-- real cases where they can step through and say
 

what -- what will a review actually involve,
 

procedurally what do we have to do step wise, and
 

then develop an itemized kind of checklist that
 

makes sure that items are not overlooked, that we're
 

examining the issues that we think are important.
 

Wanda.
 

MS. MUNN: This is what I had in mind
 

earlier when I said I see this as a two-step
 

process, and as a two-workgroup process because I
 

don't see the workload being such that the same
 

workgroup could be addressing these procedures as
 

are addressing case selection and the items we were
 

discussing earlier.
 
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DR. ZIEMER: Tony.
 

DR. ANDRADE: I could see it both ways;
 

however, I think in the -- in the interest of
 

efficiency and in saving time that indeed it
 

probably would be best to proceed in parallel, and
 

so I would suggest -- I'm not pushing anybody here 


-- but I would strongly suggest that the people who
 

came up with this -- with the Statement of Work, in
 

other words, Mike's, Mark's working group or some
 

members thereof perhaps follow through on working on
 

this. They are the most familiar with the elements
 

of what it is that we are going to want from the
 

contractor, so maybe that's a place to start. I
 

don't know you feel about that, Mark.
 

MR. GRIFFON: Very enthusiastic. I mean I
 

do want to be involved, even though I know it's
 

going to be quite a bit of work going forward. And
 

I think we have -- have met at a lot of meetings on
 

these issues and we did go to NIOSH, so we have a
 

jump-start on the whole process, so I would
 

certainly be willing to participate in that.
 

DR. ZIEMER: Who else was on that workgroup? 


I'm looking to see what our representation was. A
 

fairly good representation cross-section wise in
 

some of the areas of disciplines in the Board we
 
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310 

got. Well, we'll come back to that and ask about
 

these folks' availability and see how their
 

availability, and time, and so on. But thank you,
 

for that suggestion, that helps the Chair,
 

certainly. 


Other comments on this? Shall we proceed?
 

The Basic Report, or what is the product. 


And I think about these in two ways; one is
 

individually because as I envision it, and again,
 

I'm -- I'm throwing some ideas out and you can shoot
 

them down and tell me they're -- I'm thinking wrong
 

and you have a better idea, or we'll go from there,
 

but we -- there will be individual reports that
 

presumably, and this is based, again, on your
 

workgroup's sort of bottom line thing, and I've
 

summarized a little bit, but somehow we'll be saying
 

something about the adequacy and consistency of the
 

site and personnel data, the adequacy of the
 

interview, and the adequacy of dose reconstruction
 

and probability of causation determination, in some
 

form or another. There would be an individual
 

report of an individual dose reconstruction, and
 

after a time there would be a group of these
 

reports, which might be compiled into some sort of
 

composite that comes back to the Board which
 
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identifies strengths, weaknesses, adequacies,
 

inadequacies. And there again, that remains to be
 

fleshed out. But is this where we're headed, that's
 

what I'm asking, in the review process, is this
 

where we're headed? So let me throw that out for
 

discussion.
 

Robert.
 

MR. PRESLEY: I see the group that comes up
 

with the task order being the people that come up
 

with some type of a list or a procedure that we come
 

back to the Board with. If they write the task
 

order, it looks to me like they ought to be able to
 

come up with something that says that here's what we
 

give back to the Board, and it's going to encompass
 

all this. 


MR. GRIFFON: Yeah, and a draft, you know,
 

review report -- a report that would to the HHS. I
 

guess that's what you're -­

DR. ZIEMER: Well, one of the questions 


is -­

MR. GRIFFON: Right.
 

DR. ZIEMER: -- who does the product go to.
 

MR. GRIFFON: Right. Right, right. And I 


-- I don't disagree with what you've got up here. I
 

think I was envisioning that sort of like a summary
 
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of, over a certain period of time, a summary of
 

types of cases done, and a summary of -­

DR. ZIEMER: Oh, sure. Yeah.
 

MR. GRIFFON: -- you know, the adequacies -­

DR. ZIEMER: But the nature of the report,
 

is this kind of information coming.
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: Okay. 


Henry.
 

DR. ANDERSON: Yeah, I would think this is
 

the nature. I would think, you know, we need to, at
 

some point, separate where the contractor will
 

provide us, the Board, with something, and then how
 

do we synthesize that, whether we do it as an annual
 

report or whatever, but at some point I think we'll
 

have the individual cases, and it will be up to us
 

to interpret how they all fit together and put
 

together that annual report, and I'm not sure until
 

you've had a chance to look at them and look for
 

patterns, and the other would be consistency, I mean
 

have they applied the same thing, same approach
 

every time. And you may end up with the same
 

result, but if it's approached in a different way I
 

think we need to look at are we going to recommend, 


first we have to say if it's inadequate, we could
 
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say it's adequate, but we see there's some room for,
 

you know, some more consistency, or, you know, the
 

approach, so I think that has to be our subcommittee
 

and our group. I wouldn't want to do that summary
 

too frequently, I would say probably on an annual
 

basis, and then that report would be the one the
 

Board sends on to the Secretary, but we really have
 

to do that synthesis in how we do that I think it's
 

hard to flesh that out until you've had a chance to
 

look at at what that produces. But I wouldn't want
 

a contractor to basically be doing our
 

interpretation of it. They're doing the nuts and
 

bolts in pulling it together.
 

DR. ZIEMER: Thank you. 


Tony, then we have Roy, and then Robert.
 

DR. ANDRADE: I don't disagree with anything
 

that's been said. I think ultimately the report is
 

going to address the very last bullet. It's going
 

to -- in my mind I think it should be some sort of
 

composite from several cases, perhaps a few cases in
 

the beginning; it's -- it really is the adequacy of
 

the dose reconstruction. And the first two bullets
 

may be elements that are culled out specifically in
 

case there's weaknesses, or strengths. But I would
 

only envision an individual's -- a redacted
 
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individual's dose reconstruction being brought to
 

light if -- if some major issue had been found in -­

in the review.
 

DR. ZIEMER: Yeah. Certainly, I don't think
 

any of us envision a report that would -­

DR. ANDERSON: No.
 

DR. ZIEMER: -- cull out individuals, other
 

than say there was an example of something or other,
 

you may not even necessarily identify a site because
 

we need to be careful, but certainly this would be a
 

composite type of report ultimately, based on
 

individual reports.
 

I think we have Jim, and then -­

DR. MELIUS: I think we had somebody else.
 

MS. ROESSLER: Roy was.
 

DR. ZIEMER: Roy. I'm sorry, Roy, then Jim,
 

and then Gen.
 

MR. DeHART: I think the Board has -- also
 

has the obligation that as we're considering policy
 

and procedures for reports that we must consider
 

what happens if we find a fatal error. By that, I
 

mean something that's going wrong consistently and
 

we -- we need to step in and the Board must know how
 

we're going to do that in advance.
 

DR. ZIEMER: Okay. So we have a lingering
 
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question. I don't know where we hang that right
 

now. And we've -- we've all proceeded as if maybe
 

that won't happen, but we don't want to be like NASA
 

and second guess. And I don't mean that in a
 

derogatory way, either. Unfortunately, sometimes
 

fatal errors do occur, so what do -- what do we do
 

in that case. And this isn't going to be done in a
 

vacuum because there will be periodic reporting, and
 

NIOSH will be aware, obviously, if there are
 

concerns that start to emerge, so I don't anticipate
 

that there will be, you know, out of the blue,
 

surprises, that all of a sudden somebody says you
 

guys have been doing the wrong thing for the last
 

three years. That might occur, I mean somebody
 

might say that, but I think it's unlikely.
 

Jim.
 

DR. MELIUS: I actually was going to make
 

the same point, and I hope Larry doesn't interpret
 

that as being any statement on the likelihood that
 

we'll find a problem, but I have nothing more to
 

add.
 

DR. ZIEMER: Gen.
 

DR. ZIEMER: On your last point there you
 

mention dose reconstruction and probability of
 

causation. It's quite clear that this is a dose
 
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reconstruction audit. I'm not sure that probability
 

of causation comes into it, only as to how the dose
 

reconstruction inputs to it. I think that part is
 

something that the Board does on an ongoing thing
 

and really is not a part of the audit function.
 

MR. GRIFFON: I think this is -- I think
 

this is something that Jim Neton has taught us over
 

the working group sessions that I think we're
 

looking at adequacy of dose reconstruction for
 

purposes of POC determination.
 

MS. ROESSLER: Yeah. I think the wording
 

should be made clear.
 

MR. GRIFFON: Did I get that right?
 

DR. ZIEMER: Well, yeah, and they simply end
 

up being linked here because POC is basically the
 

outcome of the dose reconstructions. Yeah, point
 

well taken.
 

MR. NAMON: Dr. Ziemer, I'm just going to
 

point out that there's also kind of a legal
 

distinction there because the POC determination is
 

not made by the Department of Health and Human
 

Services.
 

DR. ZIEMER: Yeah. Yeah, understood. We'll
 

just consider it in this last one, strike the POC
 

from our minds, it's not really there virtually. 

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Okay, Henry.
 

DR. ANDERSON: Yeah, I was just going to
 

follow up on Roy.
 

DR. ZIEMER: The jury will disregard the
 

POC.
 

DR. ANDERSON: Jim's comment was, I think
 

going two steps back when we have kind of
 

procedures, you know, any -- any problem will appear
 

as a first case, and it would seem we just need to
 

have the flexibility in our case selection that if
 

something looks like there may be a problem, we
 

would then immediately move to look at other similar
 

cases, so you would have an investigative process
 

there that it wouldn't say there's a fatal flaw
 

based on a single -­

DR. ZIEMER: Right.
 

DR. ANDERSON: -- case. You'd want to see
 

is it a pattern, and so we would then -- we just
 

need to have that procedure in place to move forward
 

from there and have that flexibility.
 

DR. ZIEMER: Thank you. 


Robert.
 

MR. PRESLEY: When we talked about this in
 

the working group we talked about a -- a group,
 

subgroup coming in and reviewing, before our meeting
 
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with our contractor, the cases that we had selected. 


And then the way we had envisioned this -- and Mark,
 

jump in here if I'm wrong -- is that we would come
 

into the Committee as a whole with a recommendation
 

that we've gone through X number of dose
 

reconstructions, and that we find those to be
 

adequate and correct, or we find 11 out of 10 -- or
 

11 out of 12 to be adequate and correct, and we
 

found one that we would like to send back and have
 

some work redone on it at that point in time so we
 

don't wait, so I -- I consider something, some type
 

of a report to be done monthly, or every time we
 

meet, and then down the road, maybe a yearly report
 

back to the powers that be.
 

DR. ZIEMER: Right. And actually, that -­

that issue becomes part of our procedures for the
 

review; what is the output, and that can include the
 

frequency of reporting to the Board, the frequency
 

of reporting to the Secretary of Health and Human
 

Services, or whatever. Those -- those remain to be
 

refined. I -- I hadn't envisioned, for example,
 

sending a letter to the Secretary every month
 

telling him what the findings were, but -- and I'm
 

sure he's not interested in that either, but an
 

annual report might be quite appropriate. But
 
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certainly the Board wants to be apprised on a
 

regular basis.
 

DR. ZIEMER: Other comments.
 

David, please.
 

MR. NAMON: Just one general point I wanted
 

to make sure the Board was aware of, which is that
 

for this whole review process there's going to be
 

some significant proxy considerations to take into
 

consideration, not the least of which is that the
 

Subcommittee and the Board operate in public, and
 

identifying individual claimants is a significant
 

problem. Ordinarily, we would have to redact
 

reports to the point where they're not recognizable
 

to someone who would have been a coworker of that
 

person, so, which is obviously a pretty significant
 

concern. So just something for you all to keep in
 

mind as you're considering how this is going to
 

work.
 

DR. ZIEMER: Yes, and I don't think the
 

Board anticipates discussing individual cases in
 

Board meetings. The reporting would always be done
 

in terms of groups, statistical summaries of cases
 

reviewed and that kind of thing. Is that not
 

everybody's -­

Robert, you have a comment?
 
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MR. PRESLEY: Yes. On that, what we have
 

talked about in the Committee is coming up with a
 

group to do these with an alternate, and if somebody
 

recognizes that, say Savannah River, they worked at
 

Savannah River, then they would excuse theirself and
 

the alternate would step in. That's the way we were
 

envisioning this happening, right upfront.
 

MR. NAMON: I think you still have the
 

concern that if the Subcommittee is operated in
 

public that -- that you'd still face the possibility
 

that the people who are involved would be discussing
 

matters that the public would then be able to
 

identify individuals. I'm sure this is something we
 

could work out if the time comes, but I wanted to
 

make sure that you all were aware that there be a
 

need for significant redaction.
 

DR. ZIEMER: Thank you. And we are
 

certainly aware of that.
 

Henry.
 

DR. ANDERSON: Yeah, it seems to me that if
 

there is something where details need to be
 

discussed by the Board we do have a mechanism to
 

have it be a closed session, just as we did when we
 

talked about the financial aspect; so it's one thing
 

for the written report obviously, to be sure that,
 
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you know, that doesn't have any detail, but if -- if
 

an issue comes up that becomes, you know, where
 

there's disagreement on the review group or
 

something and we need to go over the specifics of a
 

case, it would seem that we could, in fact, close
 

that from the public for the discussion of
 

confidential information just as we did with the
 

contract discussion.
 

DR. ZIEMER: Further comments on this item?
 

(No response.)
 

Now, I have one other item which I'm
 

debating in my own mind whether to show you. How
 

many want to see it?
 

DR. ANDERSON: Go ahead, take a chance.
 

DR. ZIEMER: What -- well, I'm going to hold
 

it until after the break. 


What I have is a -- I'm still -- I'm still
 

trying to make sure we're on the same page as to
 

what a Basic Review report looks like, and the
 

starting point is the Individual Review. And I have
 

kind of a strawman Individual Review report, and
 

then the only reason for showing this is to make
 

sure content wise that we have captured the salient
 

points that need to be in the review. And this
 

would serve then to assist the workgroup which would
 
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come up with that. They can use it as an example of
 

what not to do, or they can use it as an example of
 

what they should do, or they can start from scratch. 


But we'll save that until after the break, how about
 

that. So let's take 15 minutes and then we'll -­

oh, a comment first.
 

MR. ELLIOTT: We -- we were just kibitzing
 

here a minute about Henry's comment. It's not clear
 

to me that we can go into closed session for that
 

purpose, whether the Privacy Act requirements would
 

trigger a closed session. We're going to -- I'm
 

asking the counsel to check into that because I
 

think that is important for us to determine.
 

DR. ANDERSON: Yeah, that would solve a lot
 

of problems if we could.
 

MS. MUNN: But that's not clear to me,
 

either. It was my understanding that Executive
 

Sessions related only to personnel and legal
 

matters. 


MR. ELLIOTT: And financial. Let me, for
 

the record state that all the Board members are
 

bound by the Privacy Act as special government
 

employees. The contractor that you will hire will
 

be bound by the Privacy Act. But when you come
 

before, into the public meeting, we -- we have
 
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problems and we need to be very careful and diligent
 

in our redaction efforts are -- are making sure that
 

no one can determine who might have been talking
 

about in a public forum, so.
 

(Whereupon, a break was taken.)
 

BY DR. ZIEMER: (Resuming)
 

We'll delay the administrative housekeeping
 

for just a little bit because Cori has some things
 

she needs to take care of first. So I think we can
 

continue with issues related to completed dose
 

reconstruction reviews. 


Let me remind you that we still have before
 

us the -- the issue of the decision on who will
 

administer the contract, do the procurement on
 

behalf of the Board. 


Also, I want to finish what we were talking
 

about here, and maybe we'll do that first and then
 

move to the procurement issue. 


The last thing that I talked about to show
 

you is based on -- I will need the slides up -- is
 

Jim here?
 

MS. DiMUZIO: No. I will.
 

DR. ZIEMER: Okay. Yeah, it's that one. 


Just open that. It's a Word document. This is not
 

a Power Point, it's a Word document. I just want to
 
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go through that.
 

Now, for reference, if you would move into
 

the tab called Discussion Documents, the Request for
 

Contract document, and go to page 16 and 17; page 16
 

and 17 was the Basic Review. Now, what I did here,
 

and I see already that sometimes when you close
 

these programs and reopen them the automatic
 

formatting overrules everything you did. 


DR. ANDERSON: You mean 1 and 2 aren't the
 

most important?
 

(Laughter.)
 

DR. ZIEMER: In any event, the only thing I
 

did here was take the Basic Review items as they are
 

here, and I've transformed them into a form format. 


Now, this -- this serves two purposes: I'm really
 

asking the group is this what we want an Individual
 

Review Report to look like? I don't know if we do. 


Or does it at least capture what it is we want on
 

the Individual Reviews. And we don't have to -- we
 

don't have to come to an approved form here because
 

this clearly is going to go to the workgroup. But
 

just as a point of guidance for the workgroup, all I
 

did was, you know, this was something that I just
 

ended up doing after I was thinking about the other
 

stuff last night, I asked myself the question what
 
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would a review report look like. And based on what
 

was here, I just put it in this format.
 

So let me just put it out here, and we don't
 

have -- you can react to it or whatever, but -- and
 

I don't know if there's a way I can move this up and
 

down. Probably not. 


So I have Henry -- can you sit there on a
 

chair Henry, to just -- well, don't change the zoom.
 

DR. ANDERSON: I was going to make it
 

smaller and then the whole page will be there.
 

DR. ZIEMER: Yeah, and then we won't be able
 

to read it. It's hard enough to read it. Just go
 

over to the side there -- yeah, we can scroll it.
 

Okay. So it says: Were all requested data
 

from the site received or obtained? Yes. No. 


Comment. 


I don't know if that's adequate. Were data
 

-- were the data, should it say: Used for
 

documentation of POC or we should say of dose
 

reconstruction -- it's a new abbreviation for dose
 

reconstruction -- adequate? Yes. No. Comment. 


And then a whole section of questions relating to
 

interview: Were incidents or occurrences
 

appropriately addressed? Yes. No. Comment. Were
 

monitoring practices appropriately addressed? Yes. 

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No. Comment. Were personnel protection practices
 

appropriately addressed? Were work practices
 

appropriately addressed? And in all of these cases
 

it's: Yea. Nay. Comment. And maybe all of these
 

can't be answered by yes or no because it may not be
 

clear cut. Is the interview information consistent
 

with the data used for dose estimate? If -- and
 

here -- wait, go back -- If no, is there reasonable
 

justification for the inconsistencies? Again, this
 

comes out of the document. It's a little different
 

than just a pure comment. 


Yeah.
 

MR. GRIFFON: Yeah, I think it's a good
 

starting point. I mean I -- I'm glad I didn't draft
 

the same thing last night because I was thinking
 

similarly. And I think that this would be a good
 

starting point since I have to kind of test this
 

form and see if it's sufficient and -­

DR. ZIEMER: That's right. You actually --


it has to be tested with some real cases and so on. 


Were the assumptions used in the dose
 

determination appropriate? Yes. No. Did the
 

assumptions used resolve issues in favor of the
 

claimant? That is, give claimant the benefit of a
 

doubt. Were the dose calculations appropriate and
 
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sufficient for determination of -- again, we should
 

say dose reconstruction. Actually -- actually, this
 

is the right question -­

MS. ROESSLER: That's okay. Yeah.
 

MS. MUNN: Uh-huh (affirmative). 


DR. ZIEMER: -- were they appropriate for
 

determination of probability of causation. Were the
 

data used consistent with rad monitoring protocols? 


Was the treatment of missed dose done properly? Was
 

the treatment of unmonitored dose done properly? 


And then I put a catchall in. 


So, I guess the only thing I'd ask here is
 

this sort of along the right track?
 

MS. ROESSLER: Yes.
 

MR. PRESLEY: Yes.
 

MS. MUNN: Yes. You're fine.
 

DR. ZIEMER: Okay. 


DR. MELIUS: Can I?
 

DR. ZIEMER: Yeah, Jim.
 

DR. MELIUS: I think it's along -- I think
 

it is along the right track in terms of the report
 

that we would have for the Board, how it would be
 

reported back to the Board. I'm thinking that as
 

the Board or the workgroup -- however we, you know,
 

set that up -- works with the contractor we probably
 
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want a longer form where they would fill in details. 


And this might address some of these privacy --


DR. ZIEMER: Well, in fact -­

DR. MELIUS: -- issues also that would -­

DR. ZIEMER: -- I'm actually looking at this
 

as a report on an individual one right now because
 

you would have to pool this to get your composite,
 

and in the comments part maybe needs to be fleshed
 

out in a different way, but more specifically.
 

DR. MELIUS: Just thinking about it though,
 

I would think that with the Board members
 

interacting with the contractor, they're going to -­

I would think that we would want the contractor to
 

provide more detail in a report to the Board members
 

on that -­

DR. ZIEMER: Oh, I'm with you, yeah, yeah.
 

DR. MELIUS: -- I would think that it would
 

include a work history kind of summary that would
 

then fill in some details -­

DR. ZIEMER: Right.
 

DR. MELIUS: -- of -- of what kind of
 

personal protection, what -­

DR. ZIEMER: This is more like the executive
 

summary.
 

DR. MELIUS: Exactly. Yeah, yeah, yeah. I
 
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think that's -- this kind of thing would be
 

appropriate to come back to the Board, the overall
 

Board, that it would be the basis for, you know, a
 

summary report and provide, you know, the categories
 

and the consistency for that. But there may be
 

another form on top of that, that they would -- so I
 

think -- the point I was trying to make was I think
 

as the workgroup works on the procedure for review
 

and does some of these mock reviews and so forth,
 

that I think they will, you know, sort of develop a
 

series of forms, and one will be a more detailed
 

one, then one less detailed one according to that. 


And then they have to make sure that the detail
 

would cover each of these points. 


DR. ZIEMER: Good. 


Other comments?
 

Now, we may be ready to move to an actual
 

appointment of a working group, I think on at least
 

or some or all of these tasks that we talked about
 

this morning. Are we at that point? Are you ready
 

to do that? This would be a workgroup just to get
 

this process underway. This is not a subcommittee
 

that's going to do this long-term. This is a
 

workgroup that would deal with initial
 

identification of the available cases, initial
 
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determination of a case selection process, initial
 

development of procedures for selection of cases,
 

and procedures for the review of cases. Those are
 

the main issues that we talked about. Now, and we
 

had a little discussion about whether that's all
 

that this one Subcommittee, or one Workgroup, or
 

whether -- whether the actual procedures for the
 

review is a separate group, or a follow on activity. 


It may be that one group can dig in and do all of
 

these things and then they would report back, at
 

least at the next meeting, and tell us where they
 

are on it. 


Did you have a comment, Mark?
 

MR. GRIFFON: Well, I was just going to say
 

that I also saw a parallel test with the procedures
 

was the drafting of some of the task order language.
 

DR. ZIEMER: And the task orders, right.
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: Then let me ask, again, those
 

who were on the previous workgroup, let's reidentify
 

here. Mark chaired it, and we had Roy, and Robert,
 

Gen, and Rich. That's two, three, four, five, five
 

individuals. Let me ask if you five are interested
 

and available to participate in this -- this next
 

workgroup activity. I don't -- I don't think you
 
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331 

need to feel obligated in terms that you know your
 

own schedule, but you also have some familiarity
 

with the -- the thinking process that went into
 

developing those procedures.
 

Roy.
 

MR. DeHART: I'm certainly interested, but I
 

will be out of country almost for the entire month
 

of April. That tends to be a critical time.
 

DR. ZIEMER: So we may need to find someone 

for you. 

Robert? 

MR. PRESLEY: I'm available. 

DR. ZIEMER: Available. 

Gen? 

MS. ROESSLER: I'm interested and I'm
 

available. It kind of depends on how much time it
 

will take and when. I mean I have my calendar with
 

me. I think I can work it out.
 

MR. ESPINOSA: Is the intent still to have
 

the working group sessions or working group meetings
 

prior to the Advisory Board?
 

MS. ROESSLER: That's what I thought.
 

MR. GRIFFON: I think we'd have to have them
 

separate, yeah.
 

MR. ESPINOSA: I mean it won't happen like 

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-- I mean we're not going to piggy-back the Advisory
 

-- we won't piggy-back the Advisory Board?
 

MR. GRIFFON: We may. It may be both.
 

MR. ESPINOSA: It may be both.
 

MR. GRIFFON: I would see at least a need to
 

go to Cincinnati as a separate meeting -­

MR. ESPINOSA: Okay. 


MR. GRIFFON: -- not necessarily tied in
 

with a Board meeting, and depending on what we find
 

out about SEC Rules, but not necessarily tied into
 

that.
 

DR. ZIEMER: Tony.
 

DR. ANDRADE: Paul, I guess I would suggest
 

perhaps getting a sense of the Board on whether
 

starting two parallel efforts with smaller scopes of
 

work. In other words, one looking at procedures in
 

developing the task orders, for example, that might
 

be a one-day activity, or even less; and then the
 

other, developing the administrative procedures for
 

case selection, case availability, and that sort of
 

thing. If -- if we can reduce the work scope and
 

have two working groups, so to speak, you know -­

DR. ZIEMER: I understand that. My concern
 

would be the degree of overlap, and the fact that we
 

need to have this all on the same page in a sense.
 
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Comment, Jim?
 

DR. MELIUS: Could I suggest an alternative
 

to that, but maybe capture some of that. We could
 

have the initial workgroup get the process started,
 

and then as they define other tasks that need to be
 

done or refine those, and then we look at people's
 

availability over time and so forth because there
 

may be periods of time when people aren't available. 


It may be that that will be how it would work out. 


If this initial workgroup came back to us at the
 

next meeting with sort of an update where they
 

stand, what they see needs to be done -­

DR. ZIEMER: How far they've gotten.
 

DR. MELIUS: -- how far they've gotten, what
 

needs to be done, and then, you know, we have enough
 

people and time to do it in, then I think we can
 

sort of decide from meeting to meeting, and it may
 

very well then make sense for, you know, split the
 

workgroup or bring other people in for particular -­

particular tasks and so forth.
 

DR. ZIEMER: Gen.
 

MS. ROESSLER: Just picking up on what Jim
 

and Tony have said, I like the idea that Tony
 

brought up of people rotating on and off this group;
 

you'd have maybe a consistent core or consistent
 
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over a period of time, then as the need comes up,
 

and I could see this almost, you know, maybe in the
 

second meeting of the group that somebody rotates
 

off, somebody comes on that would be more familiar
 

with all the sites and could help with the site
 

selection; I'm thinking of Mike, for example,
 

someone like that with a specialty need rotate on. 


DR. ZIEMER: I want to caution you that
 

we're not thinking in terms of a long-term group
 

with people rotating on and off. We're talking
 

about a short-term working effort or task. This
 

would be a workgroup that reports back at our next
 

meeting, and then we will decide whether additional
 

work needs to be done. They may complete everything
 

by the next meeting. This is not a group which is
 

going to be involved in necessarily monitoring the
 

dose reconstruction activities over the next year. 


This is a group to address these immediate tasks of
 

getting some procedures into place.
 

MR. GRIFFON: Yeah, I had just a comment on
 

what Tony said. I was thinking also about that,
 

concerned about overlap, and, you know, cause there
 

-- there could be an obvious break here with the
 

procedures and the task order parts, and then the
 

selection criteria part, because the -- how are we
 
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going to stratify, what kind of sampling processes
 

are we going to use, that kind of work. But I think
 

there would be a little bit of overlap, and I -- I
 

wouldn't mind that our group take a first shot at
 

that. 


The other thing is that I think to do the
 

selection criteria, and the -- and the
 

identification of the cases is also going to require
 

some distance, and if one group is already there
 

initially, you know, I think we can probably.
 

DR. ZIEMER: My inclination is to ask the 


A-workgroup to get this underway. It may be that
 

they can report back at the next meeting, and then
 

we can see whether or not either they or some
 

modification of that workgroup needs to do some
 

additional work to complete the tasks. And that
 

would be what I would propose, and what I'm moving
 

toward here, I appoint this -- would be to appoint
 

those available who had been involved in that
 

process who are familiar with the thinking, but we
 

need to, for example, find someone to -- if Roy's
 

availability is in question, maybe somebody who can
 

fill that seat, as it were.
 

MS. ROESSLER: I thought Roy was a very
 

valuable part of this group in the first assignment,
 
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and I would suggest that we first look at our
 

calendars and see if we couldn't involve a time when
 

he could be there.
 

MR. DeHART: I have the remainder of
 

February and all of March, and would be pleased to
 

try to adjust my calendar to be available, even
 

though I will be gone.
 

DR. ZIEMER: Let me suggest the following: 


I will appoint the workgroup and maybe have at least
 

one alternate available.
 

Do we have a limit on numbers on a
 

workgroup? It has to be less than a majority of the
 

Committee membership, which would be six. We can't
 

have seven, but we can have up to six. 


We have one, two, three, four, five. And
 

the Chair might want to be present just to observe,
 

which would give us six, but who is -- Tony, are you
 

interested in being an alternate?
 

DR. ANDRADE: (Nods head affirmatively.)
 

DR. ZIEMER: Anyone else interested in being
 

an alternate? 


MR. GIBSON: Yeah, I would be.
 

DR. ZIEMER: Mike, okay.
 

DR. MELIUS: I would be willing to,
 

depending on availability, and time, and the issue,
 
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I'd be glad to help out, so.
 

DR. ZIEMER: I will ask Mark to serve as
 

Chair, if you're willing to, Mark. And then Roy,
 

and Robert -- Roy DeHart, Robert Presley, Gen
 

Roessler, and Richard Espinosa to serve on the
 

workgroup; for Jim Melius, Mike Gibson, and who
 

else, Tony Andrade -­

MS. MUNN: And I could do that.
 

DR. ZIEMER: -- and Wanda, and Henry, are
 

all available as alternates.
 

MS. MUNN: All available. Uh-huh
 

(affirmative). 


DR. MELIUS: Let's not forget Leon.
 

DR. ZIEMER: So we have a number of folks
 

available as alternates. This workgroup would
 

proceed to develop the procedures for identification
 

of available cases, the case selection process,
 

procedures for the selection of cases, and parallel
 

to that, the development of task orders, and, if
 

there's time, procedures for the review of cases. 


But they will report back at our next meeting on
 

their progress and with any recommendations that
 

they have at that time based on their experience. 


They may, by that time, have some specific
 

recommendations and they will have a better feel for
 
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the nature of the time needed to complete the tasks,
 

and whether it can be done by that workgroup or
 

whether we have to go beyond that.
 

I don't think it requires Board action for
 

the appointment of a workgroup. I think the Chair
 

is empowered to do that. Of course, any group is
 

empowered to challenge the decisions of the Chair by
 

motion, but if that's a group -- are there any
 

objections to that?
 

(No response.)
 

DR. ZIEMER: There appear to be no
 

objections, so we will proceed on that basis. I
 

will ask the Chairman of the working group to work
 

with the individuals to find a suitable meeting
 

time. I think you can do that individually, you
 

don't have to do that as a group.
 

MR. GRIFFON: Before we leave, I would
 

propose maybe we can all get together and look at
 

our calendars.
 

DR. ZIEMER: And let the Chair know what
 

your plans are. 


And, Larry.
 

MR. ELLIOTT: Just for the record, you've
 

clearly defined the charge for the working group. 


DR. ZIEMER: Yes, I -­
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MR. ELLIOTT: That's one thing -­

DR. ZIEMER: The charge was to develop
 

procedures for identification of available cases, to
 

develop a process for case selection, to develop
 

procedures for the selection of cases, and
 

procedures for the review of cases, if there's time. 


Those are the tasks that this workgroup is supposed
 

to do, and in parallel with that, develop a task
 

order.
 

MR. GRIFFON: The other thing as far as
 

scheduling a meeting with the working group, we
 

might want to ask Larry when is a good or bad time
 

to be at NIOSH and availability of staff, things
 

like that.
 

DR. ZIEMER: It's always a good time to go
 

to Cincinnati.
 

MR. PRESLEY: Or is Jim going to be able to
 

help us on this?
 

DR. ZIEMER: Well -­

DR. NETON: I was just checking.
 

DR. ZIEMER: Well, can I ask that you all
 

work that out?
 

DR. ANDRADE: A quick question. Do you want
 

this initial working group to at least brainstorm on
 

case selection criteria as part of their charge?
 
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DR. ZIEMER: Yes, that's one of the -- that
 

was a part of it, yes. Didn't I say that? Yes,
 

that is definitely part of it.
 

Now, I'd like now to focus on -- I'm going
 

to focus on the issue of the procurement. We -- we
 

have discussed already two options; one option is to
 

proceed with the procurement under CDC; another
 

option was to have the procurement done through the
 

Department of Labor. Let me ask first if any Board
 

members wish to identify any additional options?
 

(No response.)
 

There appear to be none. Then I propose
 

we'll proceed as follows: Number one, if the Board
 

wishes to proceed with NIOSH/CDC as the procurement
 

agent, then no action has to be taken because that's
 

the track we are currently on. If the Board wishes
 

to utilize the Department of Labor as the mechanism
 

for the procurement, then we will ask for a formal
 

motion to do so. And so the Board -- and so the
 

Chair will now entertain a motion, if anyone wishes
 

to make a motion, to move the procurement to the
 

Department of Labor. Is there anyone who wishes to
 

make such a motion?
 

(No response.)
 

DR. ZIEMER: The Chair hears no such motion. 

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In the absence of a motion, I will declare that we
 

will proceed with the procurement through Centers
 

for Disease Control, and instruct Larry to proceed
 

along that path. 


And we have some idea of what the timetable
 

is, based on yesterday's discussion.
 

Now, I'd like to ask the working group that
 

prepared the document -- Request for Contract
 

document, if they have any additional changes or
 

modifications that need to be made in the document
 

before we proceed with the procurement? You will
 

recall yesterday Larry indicated that if they are -­

if we are to proceed right away we need to confirm
 

that this is the document.
 

Mark.
 

MR. GRIFFON: We had -- you probably recall
 

the end of last meeting I had worked with some other
 

folks on some draft amended language for Attachment
 

A, specifically in the Conflict of Interest section
 

there was concerns on the language being too, I
 

guess, too limiting, and we wanted to make sure it
 

was consistent with an evaluation of conflict of
 

interest rather than -- rather than eliminating all
 

possible bidders, so we did redraft an Amendment and
 

I would propose to offer that now for -- to amend
 
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Attachment A.
 

DR. ZIEMER: Could you identify specifically
 

the section and part of Attachment A?
 

MR. GRIFFON: It's Attachment A, Section E,
 

Conflict of Interest.
 

DR. ZIEMER: And item number?
 

MR. GRIFFON: The entire section.
 

DR. ZIEMER: Give us a paragraph. This is
 

for the recorder, so -­

MS. ROESSLER: Paragraph E.
 

DR. ZIEMER: All right. Give us a page
 

number.
 

MS. ROESSLER: Page 9.
 

MR. GRIFFON: It's page 9 -­

DR. ZIEMER: Page 9.
 

MR. GRIFFON: -- on to page 10, it's Section
 

E.
 

DR. ZIEMER: And the particular paragraph?
 

MR. GRIFFON: It's the entire Section. 


We've amended the language for the entire Section. 


Some of it will be similar, but I -- and I have that
 

available if we want to get to it.
 

DR. ZIEMER: I think we need to identify
 

what the change in language would be. Okay. We -­

we have that on a disk. It will take just a minute
 
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to load that, and while that's being loaded, can you
 

describe for the Board the nature of the change in
 

language that is being proposed before we actually
 

see the words?
 

MR. GRIFFON: In a nutshell, I'll try. 


Basically -­

DR. ANDERSON: Is it here somewhere?
 

MR. GRIFFON: No, it's -- I've got to get it
 

on disk and give it to you. 


Basically, we attempted to, rather than have
 

criteria that said -- that looked at, for instance,
 

the potential bidder's work history with DOE, AWE
 

sites and we said that -- I think the language as it
 

exists now says something to the effect that if
 

they've had any work -­

DR. ZIEMER: In the past two years.
 

MR. GRIFFON: -- in the past two years, then
 

they're excluded from even entering in, you know,
 

it's a black-line sort of criteria, and we rewrote
 

that to say that that work history with DOE, DOE
 

contractors, etcetera will be considered in the
 

evaluation of conflict of interest, but not
 

necessarily an exclusionary statement. I guess that
 

sort of summarizes.
 

DR. ZIEMER: Okay. While the words are
 
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being detected and selected, and put up, we can
 

discuss this.
 

DR. MELIUS: On a related issue to how NIOSH
 

is going to manage the contract, and I guess -- I
 

don't think we -- I don't believe we've talked about
 

it before, at least not directly, at least I don't
 

recall, is to how it would be managed within your
 

group, Larry, within OCAS, or is there an
 

alternative for technical or contract oversight
 

within other agencies, other parts of NIOSH, I
 

should say, or other parts of the CDC? And my
 

concern is that -- that there be an issue that comes
 

up where there is conflict between the Board, or -­

I don't want to say conflict -- disagreement between
 

the Board and you or your staff over what could be
 

done, or how the contract is being handled, or the
 

oversight provided for that. And that that would -­

that you or your staff would be telling the Board
 

that no, we can't proceed with this task or
 

whatever, or access to records, or something like
 

that, or the process that would -- and you would be
 

telling us no, we would want to go forward, and that
 

would, I think, put you and your staff in a very
 

awkward position. It would be, you know, in
 

appearing to -- appearing to be impeding our review. 

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And I just didn't know if there were alternatives in
 

terms of either technical or contract, or say that
 

it was being from another part of NIOSH or a part of
 

CDC that would help to obviate that issue. 


MR. ELLIOTT: The only time that anyone
 

would be saying no to this Board in a task order
 

format is when you put something on the table that
 

would be outside the boundaries of the FAR, so
 

outside the procurement requirements. We're going
 

to be, as I said earlier, walking a very fine line
 

here to make sure that we don't influence the
 

Board's direction otherwise, so. Are there other
 

places within CDC, I think there's one CDC
 

Procurement Grants Office, that's where this will go
 

to, you know, so that's where the contracting
 

officer will be. It will -- Martha DiMuzio, as my
 

program analyst, will monitor the expenditures. We
 

have to keep that inside OCAS because that's where
 

the funding -- funding source is, otherwise we have
 

to do some transfer of funds and that becomes
 

somewhat problematic, as you may know; so certainly
 

I don't see any conflict in that regard. I think we
 

will, of course, need to have a -- what's called a
 

technical monitor assigned to this procurement that
 

serves as the contracting officer's technical
 
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liaison, if you will, to make sure that what the
 

Board's task orders are as they come forward if
 

there are questions at the contracting officer level
 

that somebody can explain, a technical background. 


We are fully aware of where we stand in this regard,
 

and, you know, we're going to march accordingly to
 

make sure that we don't appear to be, again,
 

influencing or providing direction to the Board. 


This is your -- your work and your product; we're
 

just going to serve to facilitate it. That's all I
 

can do to answer your question.
 

DR. ZIEMER: Jim, let me also add to -- to
 

the discussion that ultimately this Board reports to
 

the Secretary of Health and Human Services, and I
 

would suppose that in the unlikely event we had some
 

kind of a major disagreement on some issue that an
 

appeal could be made at a very high level, which
 

would certainly -­

DR. MELIUS: There are possible situations;
 

for example, review -- more in-depth reviews, about
 

access to records, obtaining records, and so forth
 

that I think could become problematic. I'm not
 

saying that we need an alternative, but I -- I think
 

all those procedures need to be worked out fairly
 

carefully so that we try to avoid conflict or a
 
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potential problem in -- in terms of this issue, so
 

we don't put NIOSH in the position of -- or the
 

Board in the position of being in conflict with
 

NIOSH, and you -- you know, Larry, and Larry's staff
 

being seen to hold up or attempting to thwart a
 

quality review. And it may not -- you know, again,
 

I'm not saying it's going to be somebody's fault
 

doing it purposefully, but just giving the
 

appearance of doing that, and -- and I think we need
 

to think about it. Maybe that's something as we get
 

along. I don't think it has to be done now, but as
 

we get along with the task group, the working group
 

ought to be thinking a little bit about it as they
 

outline what the procedures are going to be for you,
 

and is there a potential -- are there potential
 

problems with access and information, what do we do
 

in those instances, and so forth.
 

MR. ELLIOTT: I just can't envision or
 

imagine -- maybe you can help me out here. In your
 

example, where, how would it come about that you
 

would be limited in access to information or
 

records? I mean -­

DR. MELIUS: Well, if there were long delays
 

in obtaining information, or if there was problems
 

with trying to obtain additional information, which
 
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could come up in terms of the more in-depth reviews,
 

so -- because remember, the more in-depth reviews
 

can be some way at looking at how complete and
 

thorough you -- your staff was, or your contract
 

staff was in obtaining information.
 

MR. ELLIOTT: But these are completed dose
 

reconstructions; they are a snapshot in time, so
 

whatever information was used, whatever site profile
 

was available at the time to complete the dose
 

reconstruction should abe already in the house, in
 

our hands, and you have immediate access to it.
 

DR. MELIUS: Yes, but we're going to be
 

looking at how adequate that was, was there missing
 

information.
 

MR. ELLIOTT: If we don't have the
 

information, how can we limit your access to it? 


DR. MELIUS: Well, because we will be
 

looking for additional information that you missed, and
 

there's, I mean -- yeah, yeah, and from DOE. I mean it's
 

not -­

MR. ELLIOTT: Well.
 

MS. ROESSLER: If you can't get it, you
 

can't get it.
 

MR. ELLIOTT: I don't know how to answer
 

this question because I just can't -- I can't seem
 
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to conceptualize the instance -­

DR. ZIEMER: It doesn't sound like a
 

situation where NIOSH is attempting to thwart the
 

review process.
 

DR. MELIUS: The -- the issue is going to be
 

how the -- the conduit to getting information, for
 

example, from DOE, is going to be the -- NIOSH. 


We're not going -- the Board is not going directly
 

to DOE for information. And you have the same 


issue -­

DR. ZIEMER: Well, you're perhaps
 

identifying something where the Board might be
 

seeking more information from DOE, where in the
 

normal review process we might -- the review might
 

identify that some information is inadequate;
 

whether the review has to actually go out and
 

therefore get that information is -- it seems to me
 

is a separate issue from the review process. The
 

review process is -- is in place to identify, for
 

example, adequacy or inadequacy. If it's
 

inadequate, then that is reported, whether now
 

something has to be reopened and more material, it
 

seems to me now is something other than the review
 

process, but I -- that's how I'm reacting to that.
 

MR. GRIFFON: I mean this is the question
 
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that we've thrown around for a while on the Board,
 

but I guess a question of was sufficient effort put
 

forth in the dose reconstruction process to obtain
 

all of the relevant records, and if -- if -- I can
 

see a situation where NIOSH would say well, we knew
 

these other documents existed; we -- we had a
 

general description of them; we deemed them not
 

relevant. And the Board might say well, you know,
 

for whatever reason they feel that they want to look
 

at those documents and make sure that they weren't
 

relevant, just not, you know, inadvertently
 

overlooked, you know, something like that.
 

DR. ZIEMER: I think what I'm saying is it
 

seems to me that if the Board makes that judgment,
 

they can make the judgment saying that we, for
 

example, think these documents should have been
 

obtained. You can make that judgment -- you don't
 

necessarily need those documents to make the
 

judgment because once you get the documents, you can
 

say sure, look, they really were inadequate, or, oh,
 

you were right, they weren't. But the judgment is
 

that you should have had the -- we think you should
 

have had these documents, right. Do we need the
 

documents to make the judgment.
 

MR. GRIFFON: Well, if -- if -- you know, if
 
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you get in that situation where they say well, you
 

know, we had a general summary of what those
 

documents were, we believe they wouldn't have been,
 

wouldn't have been relevant and, or significantly
 

affected the outcome of the case, how does an
 

auditor sort of test that, you know, without having
 

the actual documents themselves. That's the
 

question.
 

MR. ELLIOTT: Well, how do we establish the
 

basis of that without seeing the documents ourself? 


So I don't see us doing that, I think we have to
 

have the documents in order to say they're not
 

relevant.
 

MR. GRIFFON: I'm just -- this is
 

hypothetical.
 

DR. ZIEMER: Yeah, there's a lot of
 

hypotheticals here.
 

MR. ELLIOTT: I don't see -- I don't -- I
 

truly don't see us holding you up. I don't see us
 

interfering; in fact, we're walking this fine line
 

because on the other side of the line is we could
 

use you to our best advantage to pressure DOE, you
 

know, and there becomes in that, in and of itself,
 

another conflict, if you will. I mean we want this
 

information, we want to push DOE to give us this
 
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information; we apply pressure as best we can, and
 

we leverage them. And certainly this Board has -­

has an opportunity to do that for us, okay. 


DR. ZIEMER: In fact, it would seem to me
 

that if -- if this Board saw a pattern where we felt
 

that there were lack -- there was a lack -­

consistent lack of adequate documentation that we
 

could in fact go to NIOSH with this information and
 

they could in fact, once we made such a judgment, go
 

back to DOE, for example, and say our Board has told
 

us that we need to get more of whatever it is, so,
 

in fact, could use it as a pressure point for a
 

future date. 


But I think the point is made, Jim. I think
 

we hear the point and the Subcommittee has, and -­

DR. MELIUS: Very seriously.
 

DR. ZIEMER: -- and I'm not sure what more
 

we can do on it today except to be alert and to ask
 

that that be considered as we go forward.
 

DR. MELIUS: That's all I was asking.
 

DR. ZIEMER: Right. Thank you.
 

I kind of lost track of where we were. Oh,
 

we have the --


DR. MELIUS: Waiting for Mark to get this up
 

on the screen.
 
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353 

DR. ZIEMER: We have the language up there,
 

so we want to, for the record indicate the proposed
 

changes in Item E, Conflict of Interest. The first
 

paragraph -­

MS. ROESSLER: It's not the same.
 

DR. ZIEMER: -- is not the same.
 

MS. ROESSLER: He doesn't have the same
 

document. I thought you were going to put what we
 

have here in front of us and then indicate the
 

changes.
 

MR. GRIFFON: Oh, the last one, oh, no, it's
 

different.
 

MS. ROESSLER: Maybe I'm looking for
 

something different.
 

DR. ZIEMER: Is this a proposed change in
 

the whole Section E?
 

MR. GRIFFON: The whole Section E is -- is
 

revised, yes.
 

MS. ROESSLER: So we need to compare what's
 

up there with what we have in this.
 

MR. GRIFFON: And you'll notice as you read
 

-- I wish -- I should have got printouts of this
 

actually because it's hard to read from the screen.
 

MS. ROESSLER: It is.
 

MR. GRIFFON: I don't know if we -- if
 
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that's something we can do fairly quickly, but if
 

you'll -- you will notice similar language as you go
 

through these paragraphs, but things have been moved
 

around, and -- and we grouped -- I grouped something
 

kind of called a Conflict of Interest plan, giving
 

that 10 points, and the Work History, giving that 15
 

points. And there's criteria such as those hard-


line criteria are removed, so it's more up to the
 

evaluation panel to consider their work history,
 

rather than an exclusive, you know, hard-line
 

decision.
 

DR. ZIEMER: Okay. Let me ask the Board a
 

question here: Would you like to get some hard copy
 

of this and then have a chance maybe later in the
 

morning or right after lunch to bring this to
 

closure? It's a little hard to work on -­

MS. ROESSLER: I have a suggestion that
 

might make it faster. I mean what I did was read
 

through what we have here, identified what I thought
 

were the key points, and there are about five of
 

them, and then just evaluated it for what it is. 


And what I, based on our discussions before, and as
 

far as I'm concerned I've gone through every point
 

and I feel that he's addressed them all according to
 

our recommendations, and well. I only have one
 
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question. I don't know if other people would find
 

that efficient or not.
 

DR. ZIEMER: But built into this is a change
 

in the two-year requirement as I understand it,
 

Mark, is that correct?
 

MR. GRIFFON: That's correct.
 

DR. ZIEMER: Mark is proposing that the two-


year requirement be dropped in favor of it goes to a
 

nonspecified time period and simply says that that's
 

one of the things that gets -­

MR. GRIFFON: Right. For instance, that one
 

paragraph says greater emphasis will be placed on
 

work experience within the past two years. But it
 

doesn't exclude a bidder if they've worked DOE, AWE,
 

etcetera, etcetera in the past two years, so.
 

DR. MELIUS: Can we get a -- for now, I
 

think it's a lot easier.
 

MR. GRIFFON: I think it would be easier.
 

DR. ZIEMER: Yeah. We'll ask if we -- if we
 

can get the printout so we each have it sort of side
 

by side, that will be helpful. And we'll take care
 

of some of other business in the meantime, and then
 

return to this. Is that agreeable?
 

MS. ROESSLER: Yeah. So Mark, you -­

DR. ZIEMER: And we have an issue of whether
 
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we can get a printer here.
 

MS. HOMER: I'll have to take it to the
 

front office and see if I can find somebody that has
 

this on their computer. They don't have a business
 

center at the hotel, so.
 

DR. ZIEMER: Is there a Kinko's close by?
 

MS. HOMER: There is something close by.
 

MS. MUNN: But we don't have an interim
 

edited form that shows strikings and moves and.
 

DR. ANDERSON: Well, this is all different.
 

MR. GRIFFON: It was -- see, it was totally
 

removed, so to redline, strikeout, it didn't make
 

sense the way the changes are made, yeah.
 

DR. NETON: It looks like it's only about
 

page 1 on here.
 

MR. GRIFFON: Well, I would actually say -­

and now I'm going to -- I remember this. The
 

Attachment A, if you go to the very top, Jim,
 

there's a couple of other changes. These were taken
 

from Section -- removed from Section E and put as
 

overriding factors. And because these are hard-


line, I believe these were hard-line criteria that
 

could not be, you know, you can't evaluate a bidder
 

on -- these are basically, if you meet one of these
 

you cannot bid, so I pulled those up front because
 
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it sort of doesn't make sense to -- to give points 


-- they're not even allowed to go through the
 

process is what this is saying, so those were pulled
 

up front out of Section E. I think the language
 

remained more or less the same as it was in the
 

original draft.
 

DR. ZIEMER: Well, wait a minute. 


Section E -­

DR. ANDERSON: Of Attachment A.
 

MR. GRIFFON: Of Attachment A.
 

DR. ZIEMER: Of Attachment A, okay.
 

MR. GRIFFON: So I think a printout would be
 

helpful -­

DR. ZIEMER: Yeah. We -­

MR. GRIFFON: -- of the whole thing.
 

DR. ZIEMER: -- we do need to do that. 


Let's -- and that may be -- well, originally my
 

thought was that we could kind plow along and maybe
 

even have a late lunch and finish up our business,
 

but maybe that -- we'll see what we can do to get
 

this printed up. In the meantime, let's try to take
 

care of some other issues.
 

MR. GRIFFON: It's on that disk.
 

MS. ROESSLER: We need two Coris.
 

MR. ELLIOTT: Well, I'll fill in for in for
 
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Cori while she's running this down.
 

MS. HOMER: Well, what we could do, is I
 

could do housekeeping, and then run this down and
 

get it printed and everybody break for lunch while I
 

do that.
 

DR. ZIEMER: One possibility, and I had
 

earlier given members of the public a heads-up that
 

we might want to move that Public Comment Period up. 


Could I ask if there are members of the public who
 

did wish to address the Board, and who are here, and
 

willing to that at this time. Are there any members
 

of the public who were planning to address the
 

public this afternoon -- or to address the Board
 

this afternoon?
 

MS. HOMER: Nobody's signed up.
 

UNIDENTIFIED SPEAKER: Nobody's signed up.
 

DR. ZIEMER: Nobody's signed up to address
 

the Board. Okay. Is there anyone here who is
 

wanting to do that at 2:45, and insists on waiting
 

until then?
 

(No response.)
 

DR. ZIEMER: Okay. Just as an informational
 

item, Robert Presley.
 

MR. PRESLEY: I was asked to bring this in
 

front of the Board. The Department of Labor has put
 
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out a booklet/pamphlet called Frequently Asked
 

Questions, and it's been passed out in Los Alamos,
 

and Oak Ridge that I know of. And I have had two
 

individuals come to me and say that it's causing
 

some problems. The problems are: When the
 

individual goes to the doctor and says that I have a
 

problem, I need my bills paid under workmans' comp,
 

the doctor immediately says oh, have you filed a -­

under the -­

MS. MUNN: EEOICPA.
 

MR. PRESLEY: Yeah. OWA -- I'm sorry. The
 

sick-worker bill, and if their answer is yes, then
 

workmans' comp doesn't cover this, you need to go to
 

the sick-worker bill. So they turn around then and
 

get on the phone and call the 1-800 number and try
 

to get paid, try to get what they have to do to set
 

up appointments, and they say no, you have to go
 

back through workmans' comp. So apparently all this
 

is, is causing more confusion and consternation than
 

it is doing good. And I don't know what to do about
 

it, but I was asked to bring this in front of the
 

Board as a problem. 


And I think Mark has had, or heard some of
 

the same problems that I have, so it's not -- it's
 

not just a one -- you know, one person having
 
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problems with it.
 

DR. ZIEMER: Is this a Department of Labor
 

publication?
 

MR. PRESLEY: Yes, it is. It's from the
 

Department of Labor.
 

DR. ZIEMER: Well, first, this Board is not
 

currently in the business of advising the Department
 

of Labor.
 

MR. PRESLEY: That's exactly right.
 

DR. ZIEMER: Now, there are -- is there a
 

Labor representative still here that we can refer
 

this to and -­

UNIDENTIFIED SPEAKER: I can carry that back
 

and see if we can resolve it.
 

MR. PRESLEY: That was all I was asked to do
 

was to bring it in front of the Board.
 

THE COURT REPORTER: Can I have your name,
 

sir?
 

MR. COUCH: Yeah, my name is Jeff Couch with
 

the Department of Labor. I'll certainly take that
 

back and pass that word along.
 

DR. ZIEMER: Thank you. We appreciate that.
 

DR. NETON: I'd like to just ask one
 

question, if I could. Bob, was that -- was the
 

person seeking medical treatment for cancer, or was
 
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it a non-cancer related illness, do you know?
 

MR. PRESLEY: To my knowledge, it was
 

cancer.
 

DR. NETON: Okay. 


MR. ELLIOTT: Do you know if this is being
 

handled out at the Resource Centers, is that the
 

source of this document? I mean maybe Jeff knows
 

this question.
 

MR. PRESLEY: I picked this one up when we
 

up to Los Alamos the day after our meeting in Santa
 

Fe. They were having a -- Labor was having a
 

conference up there or some type of a conference and
 

I picked my copy up up there at a conference. It
 

was being handed out, and then the one that came to
 

me through the mail was just a Xerox copy from -­

from an individual, so I presume -- I really don't
 

know where it's been handed out, but it's been
 

passed around. 


MR. COUCH: I think that is a product of,
 

you know, that comes out of one of our groups at the
 

National Office.
 

DR. ZIEMER: Okay. Thank you. Your issue
 

has been, in a sense, referred to the Department of
 

Labor for resolution.
 

Let's move on to the Board work schedule. 

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The first question is: Do we have any updated
 

information on the Special Exposure Cohort proposed
 

ruling?
 

MR. KATZ: Hi, so this is Ted Katz.
 

DR. ZIEMER: Walk us through where we're at.
 

Ted Katz of Centers for Disease Control.
 

MR. KATZ: People are working furiously to
 

try to get the NPRM published. And based on that,
 

there's a -- you know, there's a reasonable chance
 

we could -- we could have this meeting on either the
 

27th and 28th of February -- yeah, it's a -- those
 

are narrow windows here because there are other
 

conflicts too. Another possibility is a one-day
 

meeting, which would just focus, I guess, entirely
 

on this Rule, but March 3rd or March 7th are open,
 

too. Those would be on the front end of the comment
 

period, which is, I think, what you would prefer if,
 

you know, if it all works out well, and this gets
 

posted.
 

DR. ZIEMER: Without committing to any
 

specific date, is there a, sort of a expected window
 

when this is going to come out?
 

MR. KATZ: Well, there's -- I mean we're
 

hoping to be able to get it published by the 24th of
 

February. Again, it's still in review, so we could
 
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fail that, but that's what we're shooting for.
 

DR. ZIEMER: Well, let me ask it in a
 

different way. Is it likely to be out before then?
 

MR. KATZ: Well, again, there's no
 

statistics to apply to this, but -- but, yes,
 

everybody's -- everybody's working very hard to make
 

this happen.
 

DR. ZIEMER: There is a long shot then.
 

MR. KATZ: It's -- so it's not, I wouldn't
 

say it's a long shot, but --


DR. ANDERSON: But I wouldn't bet on it.
 

MR. KATZ: -- but that's what we're -- no,
 

no, that's -- I mean that's what we're shooting for
 

is all I can tell you really. It's not going to go
 

that far.
 

DR. MELIUS: If they're shooting for
 

February 24th, and given -- I mean I would hate to
 

set up a meeting for the end of that week, assuming
 

it would be out. It seems to me that the 7th is -­

that may -- I'm not sure how the availability is,
 

but that would be more reasonable and would be
 

within the 30-day comment period.
 

MR. KATZ: The 24th is giving us a little
 

bit of a safety margin, so -­

DR. MELIUS: Three days of safety margin.
 
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MR. KATZ: No, no, no. I'm saying it could
 

get published before the 24th, but that's got a
 

little bit of a safety margin in it already. Again,
 

there's problems with availability is why I'm giving
 

you these dates. There's -- the following week, the
 

week of the 13th is out because I believe Larry is
 

out of pocket that week.
 

MS. ROESSLER: What month are we in?
 

DR. ZIEMER: March.
 

MR. KATZ: March. The week of March 13th.
 

MS. ROESSLER: There's no week of March -­

MR. ELLIOTT: March 10th.
 

MR. KATZ: March 13th is in the middle of
 

the week. Sorry.
 

MS. ROESSLER: The week in which March 13th
 

occurs.
 

DR. ZIEMER: Well, as a starter, let's
 

identify -- it seems to me it's unlikely that we're
 

going to want to meet in February again; here we are
 

into the first week in February.
 

MS. ROESSLER: Oh, but it's so much fun.
 

MR. ESPINOSA: Are we looking at just a 


one-day meeting?
 

MS. MUNN: Maybe two. It depends on what 


we get.
 
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MR. PRESLEY: What I would propose, if we
 

can come in here on the 5th through the 6th, the
 

working committee could come in a couple of days
 

early. Would y'all want to meet in Cincinnati?
 

MR. ELLIOTT: We would want to do this in
 

Cincinnati or in D.C.
 

MR. PRESLEY: If we did it in Cincinnati the
 

working group could come on in early and we could -­

we could -- if everybody is available that week.
 

DR. ZIEMER: Well, it's a possibility, 


just -­

DR. MELIUS: One thought I had was, and it
 

may help with some of this flexibility is that the
 

Chair appoint a working group to prepare some draft
 

comments on the SEC regs, you know, contingent on
 

timing and so forth, so -­

DR. ZIEMER: And bring that to the Board,
 

and then -­

DR. MELIUS: Bring that to the Board, so,
 

you know, that would, I think, be more practical to
 

do the review and prepare our remarks within the
 

one-day, you know, time limit, and so forth and not
 

have to extend it over two days. I think it would
 

help the process anyway. I think we can get better
 

closure when we're there in person, rather than
 
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doing it as follow-up conference calls later.
 

DR. ZIEMER: Other comments?
 

(No response.)
 

DR. ZIEMER: We can certainly do that, but
 

let's see what availability of dates are. Let me
 

begin in March. The week of March 3rd, who has
 

conflicts besides the Chair?
 

MS. MUNN: I have a Tuesday conflict, but I
 

could, if we had to.
 

DR. ZIEMER: I'm out of the loop Monday
 

through Thursday, so I could meet on Friday.
 

MR. DeHART: I can meet on Friday.
 

DR. ANDERSON: Friday is okay.
 

DR. ZIEMER: The 7th is available? Okay. 


That's an available date. Let's look at the next
 

week.
 

DR. ANDERSON: Are you saying no, Gen?
 

MS. ROESSLER: It's kind of difficult, but I
 

could do it.
 

DR. ZIEMER: Okay. One possible.
 

MS. ROESSLER: I might have to quit my
 

regular job.
 

DR. ZIEMER: Minor details.
 

MR. GRIFFON: Are we -- have we excluded
 

February 27th and 28th?
 
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MS. ROESSLER: No.
 

DR. ZIEMER: Well -­

MR. GRIFFON: Those dates are actually
 

better for me. 


MR. ESPINOSA: Yeah.
 

MS. MUNN: Yeah, they're good for me.
 

MS. ROESSLER: I can't make it that week.
 

MR. DeHART: I can't either.
 

DR. ANDERSON: I can't either.
 

DR. ZIEMER: I guess we've excluded. Okay. 


The week of March 10th, any bad dates there?
 

MR. ELLIOTT: I can't do it.
 

MR. GRIFFON: I can't do it.
 

DR. ZIEMER: The whole week is out.
 

MR. ELLIOTT: I need a vacation.
 

DR. ZIEMER: The week of March 17th. The
 

week of March 17th, who has got conflicts the week
 

of March 17th?
 

MS. MUNN: Monday, Tuesday's okay, Thursday,
 

Friday's okay.
 

DR. ANDERSON: Friday's out.
 

DR. ZIEMER: Bad days. Okay. The 21st is
 

out. Others?
 

DR. MELIUS: The 20th is out.
 

DR. ZIEMER: The 20th is out.
 
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MR. ELLIOTT: Now you're at the last week of
 

Public Comment Period.
 

MS. ROESSLER: 17 and 18, is that available?
 

DR. ZIEMER: We're at the last of the Public
 

Comment Period if, in fact, it is out in time. 


MS. ROESSLER: 17 and 18 possible? No.
 

DR. ZIEMER: Okay. Do you want to settle on
 

a specific one of these dates? Are we talking about
 

one day then? 


MR. PRESLEY: I would think.
 

DR. ZIEMER: One day in Cincinnati.
 

MS. ROESSLER: How about if the working
 

group gets together the 17th and/or the 18th, and
 

then the Board meets on the 19th for just a one-day
 

meeting if we do what Jim suggested about having
 

another group do a preliminary on it?
 

MR. GRIFFON: The only concern I would have
 

is if there is significant changes to the SEC rules,
 

which I imagine there are, we don't leave ourselves
 

any follow-up time; we're right at the end of the 30
 

days.
 

MS. ROESSLER: Yeah, that's nervous.
 

DR. ZIEMER: Which then pushes us back to
 

approximately the 7th. 


DR. MELIUS: What about the working group on
 
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Thursday?
 

MR. GRIFFON: I'm not sure I can.
 

MS. ROESSLER: I'll just have to make it
 

work.
 

MR. GRIFFON: Yeah, the working group -- I
 

mean I would like to link it so that the working
 

group could go up maybe Thursday, or Wednesday and
 

Thursday, you know, or at least -- at least
 

Thursday. 


MR. DeHART: Okay. 


MR. ESPINOSA: That week is a little bit
 

rough, but if we can pinpoint it to where I know in
 

advance. I mean is it going to be two days for the
 

working group and then a day with the Advisory
 

Board?
 

MR. GRIFFON: I would say just Thursday.
 

MR. ESPINOSA: Just Thursday?
 

MR. GRIFFON: Yeah. 


MR. ESPINOSA: Because you've got to
 

consider a day of travel going to, and that kind of
 

throws me off if we're going to go the Wednesday and
 

Thursday.
 

MR. GRIFFON: I'm just a little nervous
 

about just giving ourselves one day. We have a
 

pretty large scope of work for the working group
 
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370 

also, and -­

DR. ZIEMER: Well, and also keep in mind
 

that we also still have a meeting in April
 

scheduled, and -­

MR. GRIFFON: Yeah, there's more
 

opportunities to go back to Cincinnati.
 

DR. ZIEMER: I don't think when we charged
 

the working group we were anticipating you would
 

only have a couple of weeks to get together, so you
 

could give us a status report, but not have
 

necessarily completed everything.
 

Okay. We appear to have reached agreement
 

that we are going to set aside March 7th, one-day
 

meeting, Cincinnati, to deal with the Special
 

Exposure Cohort. This is contingent on the
 

publication in the Federal Register actually having
 

occurred. 


And Cori, I assume in Cincinnati it will be
 

a situation where if we need to cancel you will need
 

to -- well, you're -­

WRITER/EDITOR: We can't hear you.
 

DR. ZIEMER: I was just wondering, if -- if
 

she goes ahead and blocks off hotels and then it
 

turns out the document is not available, how readily
 

she can cancel, maybe not any easier in Cincinnati
 
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371 

than anywhere else. The same problems arise;
 

penalties, and so on, at hotels. We'll have to deal
 

with it. 


Okay. I guess we've agreed on that.
 

DR. ANDERSON: Just -­

DR. ZIEMER: Henry.
 

DR. ANDERSON: I mean will we have some
 

advance warning of an actually firm publication
 

date? I mean isn't there two weeks to get it into
 

the Federal Register or something?
 

MR. KATZ: No, it actually just takes a
 

couple of days once it's cleared by the Secretary,
 

so.
 

DR. ANDERSON: Okay. 


MR. KATZ: But we'll give you whatever
 

advance notice we can.
 

DR. ANDERSON: Yeah, I was looking for, you
 

know, as far as scheduling and finalizing the
 

meeting. You're going to have to get it -- our
 

meeting has to be notified sufficiently in advance,
 

so we may have to put the meeting in the Federal
 

Register before we know that we're even going to
 

have a meeting, and canceling the Federal Register
 

meeting becomes -­

DR. ZIEMER: Now, it's been suggested that
 
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we also have a working group to do some advance work
 

on preparation of comments prior to the meeting. 


Let me ask -- that was the suggestion, let me ask if
 

there is any sort of consensus amongst Board members
 

that you want to have a working group do that. 


There seems to be a consensus.
 

DR. MELIUS: I think it would just be
 

helpful to have -- somebody have some language
 

ready. We have our prior comments.
 

DR. ZIEMER: Yeah, right. 

DR. MELIUS: We'll see what changes there 

are -­

DR. ZIEMER: I'm going to ask --

DR. MELIUS: -- and stuff like that. 

DR. ZIEMER: -- I'm going to ask -- the 

Chair will ask for volunteers to be on the
 

workgroup, a minimum of three people. Jim, Mike,
 

okay. I will be the third person and the three of
 

us will try to work out -- so this will be a
 

workgroup to draft some language for the Committee
 

as possible comments on the Federal Register notes. 


Let me ask, does that workgroup also wish to
 

come in to Cincinnati a day ahead, or we might be
 

able to do this by e-mail or phone.
 

DR. MELIUS: By e-mail.
 
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373 

DR. ZIEMER: E-mail and phone, okay.
 

Comment?
 

MR. ELLIOTT: Ted, help me here. I think we
 

can help this working group of the Board by giving
 

them a cross-look analysis of what changes were
 

made.
 

DR. ZIEMER: That would be very helpful.
 

MR. KATZ: Yeah, I was just assuming I would
 

attend that working group. How about that?
 

DR. ZIEMER: And Ted, that might be a
 

teleconference sort of thing. We'll get the
 

documents and we can talk. Thank you.
 

DR. MELIUS: Or you can come visit one of 

us. 

DR. ZIEMER: Mark. 

MR. GRIFFON: Just a point for clarification 

that the dose reconstruction working group plans on
 

meeting on the 6th, one day ahead of that meeting in
 

Cincinnati, March 6th, so we plan on working that
 

day on our tasks.
 

DR. ZIEMER: Agreed. Thank you.
 

Comment?
 

MR. NAMON: I was just going to add that it
 

was our hope that we would have one of your
 

attorneys for the dose working group, but on the 6th
 
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we will not be able to do so, but we will certainly
 

be available for other occasions to make sure that 


especially the privacy angles are covered.
 

DR. ZIEMER: Yeah, and at this point they're
 

still going to be dealing just with procedures and
 

so on, not -- not working on dose reconstructions
 

per se.
 

MR. GRIFFON: I should ask though, Jim Neton
 

if he could have any staff available?
 

DR. NETON: I should be able to.
 

DR. ANDERSON: Paul, do we have a drop-dead
 

date and a fall-back? Do we want to look at the
 

week of the 17th for a fall-back? I mean let's say
 

the 24th isn't met, and instead it's planned to come
 

out on the 5th, and so now we've got two days, you
 

know, and what -- what kind of lead time does one on
 

the workgroup to be able to read -- I guess I don't
 

us to have a one-day meeting and have those of us
 

who were out the previous week not have any chance
 

to take a look at it, so, you know, I just don't
 

want us to all get together and now we'll have
 

another gripe session about how here we are again
 

without insufficient time, so we probably now ought
 

to plan our strategy that if it doesn't come out -­

DR. ZIEMER: What is Plan B?
 
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375 

DR. ANDERSON: Yeah, what's Plan B, if it
 

isn't on the 24th, do we then go to the fall-back
 

period? It's too bad if we have to cancel rooms and
 

there's a cost, but to have a meeting with
 

insufficient time, you know, and not waste our time
 

too.
 

DR. ZIEMER: Good point. Jim, you have a
 

comment?
 

DR. MELIUS: Yeah, I was going to say the
 

contingency may be a little bit more complicated,
 

but I think we pick one day because it's going to
 

depend on when it comes out, and -­

DR. ANDERSON: Yeah.
 

DR. MELIUS: -- that we pick one day that
 

could either be an alternative meeting day, or an
 

alternative date for a conference call if we, you
 

know, can prepare preliminary comments we need to
 

finish at the 7th, but, you know, we're able to
 

finish them up later or whatever, so.
 

DR. ZIEMER: Good suggestion.
 

DR. ANDERSON: I mean what we -- we don't
 

know how -­

DR. ZIEMER: There has to be a reason.
 

DR. ANDERSON: -- how extensive the changes
 

are and then how -- how much conversation and
 
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concern will be raised by those changes. If there's
 

changes that basically reflect our advice on the
 

first set, we shouldn't have as much of a problem
 

with doing it.
 

DR. ZIEMER: How about if we pick a time, a
 

day in the week of the 17th, that could either be
 

used for a full meeting, if needed, or for a
 

conference call meeting.
 

DR. ANDERSON: Yeah.
 

DR. ZIEMER: What were the conflicts that
 

week?
 

DR. ANDERSON: Just Friday, I think.
 

DR. MELIUS: I have a conflict on Thursday.
 

DR. ZIEMER: 20th and 21st were out; 17th,
 

18th, or 19th, that's Monday, Tuesday, or Wednesday. 


Any preferences?
 

MR. GRIFFON: Well, how about the 18th, if
 

that's possible for people cause then we could have
 

the working group -­

DR. ZIEMER: Because then you still -­

MR. GRIFFON: -- meet on the 17th, if -­

DR. ZIEMER: -- have your working group.
 

MR. GRIFFON: -- that's a good day for the
 

working group, as well.
 

DR. ZIEMER: So we'll mark -- is that
 
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377 

agreeable with everybody? We'll mark as Plan B, the
 

fall-back date would be March 18th with the working
 

group meeting on the 17th, or the Dose
 

Reconstruction Review Workgroup. 


Okay. Thank you.
 

Let me ask, Cori, do we have other
 

housekeeping items?
 

MS. HOMER: Just a couple.
 

DR. ZIEMER: Yes.
 

MS. HOMER: If you want to turn to the last
 

page of your Minutes where the action items are
 

listed. There were four listed; bullet one and
 

bullet three were actually taken care of today:
 

Providing the Board with a list of sites lagging in
 

responding to records requests and a breakdown of
 

reasons why; and, an update on implementation of the
 

conflict of interest policies was requested. And I
 

believe both of those have been handled during this
 

meeting. The last one was just a projected meeting
 

dates and we've already taken care of that.
 

Just as an update, I have not signed a
 

contract, but have pending dates in Oak Ridge for
 

April 28th and 29th, and will get back with you as
 

soon as possible as soon as those dates are
 

confirmed with the hotel.
 
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378 

MR. ELLIOTT: What the Board needs to decide
 

is, you know, are those -- do they want to meet
 

again on those dates, I think.
 

MS. HOMER: Okay. 


MR. ELLIOTT: And now is the time to figure
 

out if, you know, if you're going to meet in April
 

and, you know, what do you -- I mean we talked about
 

some IREP scientific issues that we might be able to
 

explore a little bit, but what would your agenda
 

look like, I guess.
 

DR. ZIEMER: Well, particularly if we meet
 

in March on the Special Exposure Cohort. 


DR. MELIUS: I was -­

DR. ZIEMER: Well, the other -- the other
 

thing that we would be far along on the -- on this
 

issue and so I guess it would be the review
 

procedures issues, task order, and the selection.
 

DR. MELIUS: I don't know if, on some of
 

those IREP scientific issues, whether it will be
 

timely to -- if that will give you enough time to
 

prepare one of those or something.
 

MR. ELLIOTT: I think the end of April.
 

DR. ZIEMER: Yeah, this is basically the end
 

of April.
 

MR. ELLIOTT: I think HERB could be ready,
 
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that's the research branch at NIOSH, and I think
 

they can be ready by April to give you a
 

presentation on the status of DOE workforce studies.
 

DR. MELIUS: Maybe start on the smoking
 

thing or something, I don't know, just see where
 

you, how it would work out.
 

DR. ZIEMER: Okay. 


MS. MUNN: I guess I need to whine and carry
 

on a little bit about that April date. At the time
 

we were talking about them I did not realize that I
 

would be in China for the preceding two weeks, 


and -­

DR. ZIEMER: This is prior to the Oak Ridge?
 

MS. MUNN: Prior to the Oak Ridge meeting,
 

yeah. The earliest date I could be back from China
 

would be Sunday, the 27th, and probably Monday, the
 

28th, which means I have a choice of stopping on the
 

West Coast and changing my clothes, or just
 

continuing to fly to the East Coast. And I'm not at
 

all sure whether I'd be awake at all while we were
 

here. If there's -­

DR. ANDERSON: We can handle the medication
 

side.
 

MS. MUNN: Thanks. Thanks a lot. Yeah, I
 

appreciate that part. Do I get go-pills or no-go­
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pills?
 

DR. ANDERSON: I've got some military
 

contacts.
 

MS. MUNN: Yeah, yeah, if the Air Force can
 

do it, then I can do it. I guess the -- the 1st and
 

2nd would be so much better for me if it's at all
 

possible to do that.
 

DR. ZIEMER: Well, the 1st and 2nd were the
 

alternative dates.
 

MS. MUNN: Okay. 


DR. ZIEMER: In the meanwhile, Cori, did you
 

already check, are we locked into April?
 

MS. HOMER: We are not locked in.
 

DR. ZIEMER: Are the other two dates
 

available, or?
 

MS. HOMER: Those are the only two dates
 

available at the hotel in Oak Ridge; Knoxville, I'm
 

still searching.
 

DR. ZIEMER: I certainly don't object to
 

waiting till Thursday and Friday. We can still go
 

into Oak Ridge, right, without having -- we don't
 

need to stay in an Oak Ridge hotel necessarily.
 

MR. DeHART: I won't be able to be there on
 

the 1st and 2nd.
 

MS. MUNN: Roy.
 
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381 

DR. ZIEMER: Was there a reason we excluded
 

the 30th? For example, suppose it was the 29th and
 

30th, or the 30th and the 1st.
 

MS. MUNN: The 30th and 1st I could do.
 

DR. ZIEMER: Did somebody have a conflict? 

DR. MELIUS: I have a conflict on the 30th. 

DR. ZIEMER: That was the problem. Well, 

the other thing is recognizing we were trying to
 

keep this sort of early in May because there was a
 

big gap between this meeting and then, but we have
 

another meeting in between, so we could go later in
 

May if we needed to. There would be no reason we
 

couldn't do that. It might even be nicer in Oak
 

Ridge.
 

What is your pleasure?
 

MS. MUNN: The following week is -­

DR. ZIEMER: I see no urgency to meet early
 

May if we have another meeting next month anyway.
 

MS. MUNN: The following week is good for
 

me. 


DR. ZIEMER: How is the following week? 


And we're not locked in, you said?
 

MS. HOMER: No, we're not.
 

DR. ZIEMER: How is the week of May 5th?
 

MR. DeHART: I'm out.
 
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DR. ZIEMER: Out all week?
 

MR. DeHART: Yeah.
 

MR. ESPINOSA: Are you out the whole month,
 

or?
 

MR. DeHART: What?
 

MR. ESPINOSA: You were saying something
 

about being out a whole month.
 

MR. DeHART: No. That was April. I'll be
 

in China with her. Keep it quiet.
 

DR. MELIUS: We'll meet there.
 

MS. MUNN: Yeah, okay. Fine.
 

DR. MELIUS: Larry won't invite us to the
 

beach, maybe you two could invite us to China.
 

DR. ZIEMER: How about the week -- how is
 

the week of the 12th?
 

MR. ELLIOTT: I can't do that.
 

DR. ANDERSON: Okay. 


MR. GRIFFON: I think the only -- I was
 

going to say the only thing I'm a little concerned
 

about is if we start moving too far back, if we get
 

this -- which we hope we will get this contract out,
 

the clock, if I remember right, is 120 days, and
 

that will be like June -- mid June, and I'd like to
 

have these task orders like ready to go.
 

DR. ZIEMER: Yeah, ready to go.
 
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383 

MR. GRIFFON: Right, so just keep that in
 

mind.
 

MS. MUNN: So you said you couldn't make the
 

1st. Could you make the 2nd?
 

MR. DeHART: No.
 

MS. MUNN: You're out the 1st and 2nd. 


Okay. You can have your choice; you can have me, or
 

you can have Roy. Take a toss up.
 

DR. ZIEMER: This is a tough one. How many
 

favor Roy?
 

(Laughter.)
 

MS. MUNN: All in favor of Roy, all in favor
 

of Wanda?
 

DR. ANDERSON: A sleepy Wanda, or an absent
 

Roy.
 

DR. ZIEMER: Yeah, I don't like to look at
 

it that way?
 

MS. ROESSLER: What was wrong with the week
 

of the 5th, again?
 

DR. ZIEMER: That was out for -­

MS. ROESSLER: Who?
 

DR. ZIEMER: Roy. And the week of the 12th
 

is out for Larry. And is the week of the 19th
 

actually too late you think, Mark?
 

DR. ANDERSON: We've already marked that as
 
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384 

a follow-up. That was a -­

DR. ZIEMER: May.
 

MR. ELLIOTT: Yeah, we did. We already
 

marked that as May 19th and 20th was also
 

acceptable. 


DR. ANDERSON: But that was for conference
 

calls.
 

DR. ZIEMER: No, that was the regular
 

meeting time.
 

MS. MUNN: That was a regular meeting, yeah.
 

DR. MELIUS: February 19th was the
 

conference call.
 

DR. ANDERSON: Okay. 


DR. ZIEMER: I'm wondering, are we still
 

okay, I hate to meet with people having to be
 

absent.
 

MS. MUNN: Yeah, I do too. The 19th and
 

20th is fine for me.
 

DR. ZIEMER: Any objection to May 19th and
 

20th?
 

DR. ANDERSON: Where would it be?
 

DR. ZIEMER: Oak Ridge, I think.
 

MR. PRESLEY: Oak Ridge.
 

DR. ANDERSON: Because I have to be in 


San Diego on the 21st.
 
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385 

MS. MUNN: That's easy. Easy. It's a long
 

day, and you're going to a major hub. Don't worry
 

about it.
 

DR. ANDERSON: Well, I just need to get out
 

on the afternoon of the 20th, so if we end on the
 

20th at noon, I'm okay.
 

MS. MUNN: Yeah, you're going West, just
 

stay up all night.
 

DR. ANDERSON: Thanks a lot.
 

DR. ZIEMER: Okay. It appears that we have
 

consensus for May 19th and 20th for our Oak Ridge
 

meeting, as opposed to the May 1st. That's only a
 

two-week delay, so maybe we'll be okay.
 

Thank you. Any other housekeeping items
 

then, Cori?
 

MS. HOMER: Just provide Larry with your
 

written outside hours if you've worked on a working
 

group, or prep time. Please be as specific as
 

possible, so that I can submit the request
 

accurately. 


One other thing, because I haven't requested
 

this in a while. Take a look at the roster and
 

check your information; make sure it's all correct,
 

and if I need to update it, please let me know as
 

soon as possible.
 
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386 

DR. ZIEMER: Now, the only task we have left
 

to do is to address the proposed changes in Section
 

-- or Attachment A, and it's going to be a little
 

while before the -- the computers or printers here
 

has a virus I understand and they actually had to
 

send this out. I was hoping we could simply work
 

through and finish before lunch, but it looks like
 

we'll take a lunch break, and deal with that
 

immediately after lunch.
 

MR. GRIFFON: I can scroll through it.
 

DR. ZIEMER: I'll leave it up to the group,
 

but -­

MS. ROESSLER: I'd like a printed copy if we
 

can get it.
 

MS. MUNN: It makes it a lot easier.
 

DR. ZIEMER: We all have to eat lunch
 

anyway, so.
 

MS. MUNN: Yeah.
 

DR. ZIEMER: Let's do that and take a break. 


Let's try to be back here as close to 1:00 as we
 

can; if you're here by 1:00 we'll start, and finish
 

up -- certainly finish up before 2:00 o'clock, maybe
 

sooner.
 

(Whereupon, a luncheon recess was taken.)
 

BY DR. ZIEMER: (Resuming)
 
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387 

I'm going to ask Robert Presley to quickly
 

determine the level of interest for the Oak Ridge
 

meeting in a tour of ORNL and K-25.
 

MR. PRESLEY: Would anybody be interested in
 

taking -- when we go to Oak Ridge, taking a two-,
 

two-and-a-half-hour tour of the second -- the last
 

half of the second day? And what we will do is get
 

permission to go over to ORNL; drive through; talk a
 

little bit about what went on; and Larry's mentioned
 

going to the graphite reactor; we're going to get
 

permission to do that; go to K-25; drive through;
 

let you see the buildings; talk about what went on
 

at K-25; come back over to Y-12; go up on the Ridge,
 

the Overlook at Y-12; and talk about what went on in
 

some of the buildings at Y-12. That's -- you're
 

talking about two, two-and-a-half hours.
 

DR. ZIEMER: Can we see a level of interest? 


How many would want to do that if we can arrange it?
 

BOARD MEMBERS: (Board Members raise hands.)
 

MS. MUNN: I guess that sounds like a few.
 

MS. ROESSLER: In the audience, too.
 

MR. PRESLEY: The public, sorry, it will
 

only be Board members.
 

MS. DiMUZIO: Staff also?
 
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388 

MR. PRESLEY: Staff -- yes, staff can go. 


DR. ZIEMER: Okay. 


MR. PRESLEY: All right. We're talking
 

about 20 people, so we'll need a bus to hold 20
 

people.
 

MS. MUNN: Yeah, we're talking about a
 

little bus.
 

MR. PRESLEY: I'll try to set that up.
 

DR. ZIEMER: Now, the item we have before us
 

is Attachment A. And Mark and the working group met
 

during the lunch hour to give us some level of
 

assurance that the working group has agreed to the
 

changes. And Mark will lead us through these items
 

and show us where there's no change. As an example,
 

the first three items appear in the current
 

contract, or the current Attachment A, but he's
 

moved them from other locations. So lead us through
 

and show us what the changes are, and I would say
 

most of the document, there's no wording changes
 

either, but we have some that are perhaps critical
 

here, so Mark, take us through very quickly,
 

starting at the beginning there.
 

MR. GRIFFON: I can say that I'll go through
 

the new document and then we get to Section E, I've
 

opened the old document up and I've numbered the
 
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389 

paragraphs there and I can show you where we kind of
 

cut and pasted because things got moved around; a
 

lot of the language is very similar, but things got
 

moved around and it would be hard to do a side-byside, so I'll take you through Section E separately. 


But first, looking at the overall document, like
 

Paul said, the first three items were moved to the
 

front end and it's both the areas where points are
 

assigned, you'll notice, and that was because these
 

are more or less hard-line criteria; if they don't
 

meet these prerequisites, if the bidders don't meet
 

these prerequisites, they can't bid on this
 

contract, so we thought they needed to be pulled out
 

of the point system and into the front part of the
 

document. So this is the one that's been handed
 

out, Wanda, is that -- is everyone looking at the
 

one that just got handed around? Okay. 


Section A, if you -­

DR. ZIEMER: Just as a matter of interest,
 

the first item in the old contract -­

MR. GRIFFON: Well, I was going to -­

DR. ZIEMER: Okay. 


MR. GRIFFON: I'm going to do that later,
 

let's step through the whole document first, then
 

I'll go back to that, yeah.
 
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390 

DR. NETON: Excuse me, one second. What
 

file was that on here?
 

MR. GRIFFON: It's Attachment A, underscore
 

5.
 

DR. NETON: The last one in that group?
 

MR. GRIFFON: Yeah. Yeah, that's it, the
 

last one.
 

If you look at Section A, Personnel, in this
 

new document -- they're going to hand it around -­

it's all the same, to the best of my knowledge. I
 

haven't done a word-by-word through it, but I think
 

the only section that we edited was Section E,
 

actually; so Section B is the same; C is the same; D
 

is the same; E is drastically changed, but a lot of
 

the paragraphs were cut and pasted, but they were
 

modified somewhat, so we should step through that;
 

and then Section F remains the same. 


So now if you -- if you could open the old
 

document that's in our binders, if you look, for
 

instance, at the first paragraph E-1, I labeled that
 

E-1, the first paragraph in the old document, that
 

ends up being in the new document under the Conflict
 

of Interest Plan section, the 10-point section, the
 

first paragraph there. The language is not the
 

same, but the concept is the, you know, that's where
 
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391 

that concept moved to.
 

DR. ZIEMER: Which paragraph is that?
 

MR. GRIFFON: It's the second paragraph, the
 

first paragraph under the Conflict of Interest Plan
 

on the new.
 

DR. ANDERSON: Where it says Conflict of
 

Interest Plan, 10 points?
 

MR. GRIFFON: Right. And this -- I should
 

step back a second -- the section is divided up into
 

two sections; Conflict of Interest Plan, 10 points,
 

and Work History, 15 points, and the bullets that
 

sort of fall into each, that's why there was some
 

cutting and pasting from the previous document
 

because they weren't always in the appropriate
 

order, so we moved them around a little. And this
 

Plan is what -- basically what we're expecting.
 

They're not disqualifiers, it's that this is the
 

information that you should include in your plan, a
 

minimum to disclose potential, perceived, actual
 

Conflicts of Interest on -- on your team. And then
 

the Work History below, is actually -- there will be
 

15 points assigned, paying attention to the key
 

personnel staff, and organizational conflicts of
 

interest; and it goes on, but the one striking
 

difference in that section is that previously we had
 
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392 

a hard-line where we said if the bidders worked -­

the bidders were key personnel and worked with DOE,
 

DOE contractors, etcetera, etcetera, or NIOSH, or
 

ORAU within the last two years they were
 

disqualified. Well, we -- we took that out and we
 

replaced it with the phrase about that greater
 

emphasis will be placed on the work history within
 

the past two years -- work experience within the
 

past two years; so again, that gives the panel more
 

flexibility, and points will be assigned based on
 

this, but it's not, they're not disqualifiers
 

anymore, like they were in the previous document.
 

That was the idea, to give -­

MS. MUNN: That's good.
 

MR. GRIFFON: Yeah. Part of the reason this
 

arose was the concern that we would be excluding too
 

many potential bidders, and yeah, unintentionally,
 

but -- but it would have happened probably, so. So
 

then if -- if we brought -- let's see, let's start
 

at the front end of this document, the front end of
 

the new one. If you want to do a paragraph-byparagraph, these three points that I listed there as
 

prerequisites now, used to be in the -- the first
 

one was Section E of the old document, paragraph
 

number 6, which is on page 10.
 
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393 

MS. ROESSLER: Under number one, I think the
 

intent was here to eliminate anybody who's working
 

for NIOSH. And then as far as ORAU goes, that's the
 

part of ORAU under the contract -- Dose
 

Reconstruction Contract, that doesn't mean all of
 

ORAU, does it? Back in the document it does put in
 

parentheses under Contract Number 200-so-and-so, or
 

does that -- is the intent there that nobody who
 

works for ORAU?
 

MR. GRIFFON: The intent was any work for
 

ORAU. If you look back at the part of E-6, it
 

doesn't have that reference to the contract. That's
 

for another.
 

MS. ROESSLER: Okay. So anyone who's
 

currently, or in the past -- well, currently working
 

for ORAU, which is a really big group, is
 

automatically eliminated.
 

MS. MUNN: For key personnel.
 

MR. GRIFFON: Right.
 

MS. ROESSLER: Yeah, I mean I just want to
 

make sure that that was the intent.
 

MR. GRIFFON: Yeah.
 

MS. ROESSLER: I don't know that that's bad,
 

but I -­

MR. GRIFFON: That's the intent.
 
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394 

MS. ROESSLER: Okay. 


MR. GRIFFON: I think we -- we did have some
 

debate on that, but that's, if you look at E-6 in
 

the original document -­

DR. ZIEMER: It's the same words.
 

MR. GRIFFON: -- that's the same words. 


Yeah. And you'll notice Paragraph E-6 of the
 

original document was split in half, and the reason
 

for that, if you look when we get back to Section E,
 

is that we didn't want that hard-line of a criteria
 

for DOE or DOE sites, DOE contractors, but we still
 

thought the bright line should apply to NIOSH and
 

ORAU because it just -- this was too close to what
 

they'd be doing under this contract, and so we give
 

more flexibility, and if we look in Section E you'll
 

see that. And the idea there was that they may have
 

other work, and they'd be evaluated based on that,
 

so that if their other work with DOE was really
 

closely related to dose reconstruction, I think that
 

will work against them, as opposed to if they had
 

other work with DOE that wasn't in any way related
 

to dose reconstruction, I think you'd say that, you
 

know, that's fine, so. So the second paragraph on
 

the top of the document there comes from Paragraph
 

E-4 in the original document. 

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395 

DR. ZIEMER: The only change is the word
 

"additionally" in the original document.
 

MR. GRIFFON: Right. This is the expert
 

witness question that we've gone through. 


And then the third paragraph is the one that
 

Gen, that you were talking about. This says -- I
 

think, maybe I'm wrong -- but this says that anyone
 

that's under the current NIOSH contract obviously
 

can't also be on the auditing contract.
 

MS. ROESSLER: Okay. So the first one is
 

broad, and the third one is specific.
 

MR. GRIFFON: Right.
 

DR. ZIEMER: And again, this is the same
 

wording as before, the only exception being that the
 

original paragraph had the word "finally" -­

MR. GRIFFON: Right.
 

DR. ZIEMER: -- at the beginning of it,
 

which is not needed. 


WRITER/EDITOR: Say that word again.
 

DR. ZIEMER: For the third point, finally. 


The original document had the word "finally" at the
 

beginning because of the way it was sequenced in
 

here. It's just item three. But that doesn't
 

change the meaning in any way.
 

MR. GRIFFON: Then going on to Section E
 
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396 

itself, the first paragraph, as far as I can tell on
 

my quick cross walk here, is a new paragraph. And
 

that was just to put the overall goal or objective
 

of this -- this Conflict of Interest section in
 

perspective. I think a key phrase here at the end
 

of this is that, you know, the Board's statutory
 

dose reconstruction review mandate in order to
 

assure the highest degree of independence, while
 

balancing these concerns with technical
 

qualifications. So this is the idea, just to put
 

the rest of this section into perspective. We're
 

looking for balance between technical qualifications
 

and conflict of interest issues. 


And under Conflict of Interest Plan, the 


10-point section, that first paragraph comes from 


E-1 in the original document. Okay. And it looks
 

longer, so I'm assuming it was modified a little
 

bit. It generally talks about disclosure of your
 

personnel basically, and what their potential,
 

perceived, or actual conflicts would be. And this
 

is the plan itself. Okay.
 

Stop me when it's appropriate.
 

The next paragraph comes from -­

DR. ZIEMER: Mark?
 

MR. GRIFFON: Uh-huh (affirmative). 

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397 

DR. ZIEMER: Let me insert here. The first
 

part of that, I guess it's the first couple of
 

sentences are the same or similar, but then this is
 

expanded from before, including this: The entire
 

plan shall be made public. 


But doesn't that parallel what we had on, or
 

what ORAU had in their requirement?
 

MR. GRIFFON: I thought it did, yeah.
 

MR. NETON: I don't think we committed to
 

making the plan public, but we did.
 

DR. MELIUS: Yeah, I think that's -­

DR. NETON: I don't think the contract
 

requires specifically that we make the Conflict of
 

Interest plan public. 


MR. GRIFFON: That's actually in the -- in
 

the original E-1 paragraph, isn't it? 


DR. NETON: I don't think so.
 

MR. GRIFFON: E-1 in the -- in the last
 

draft that we did.
 

MR. DeHART: Yes.
 

DR. ZIEMER: Well, and incidentally, that
 

last sentence of that paragraph, Mark, is somewhat
 

similar to the second to last paragraph at the end
 

of the document, which says something about what we
 

plan to do in the future; it's not a grading or an
 
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398 

evaluation. You're sort of telling the contractor
 

that, oh, by the way, we can make this information
 

public, so it would seem to me that as an option we
 

might suggest the contracting officer, if there's
 

another place in the contract to put that, it could
 

be moved; it's certainly not part of the evaluation
 

screen itself.
 

DR. MELIUS: Though I think -- I agree with
 

that, though I think it also, to me it would be
 

helpful if I was applying for this to know,
 

understand that oh, I have to do a, you know, a
 

conflict of interest, and by the way, it's going to
 

be a public record.
 

DR. ZIEMER: Right. I'm saying it -- it
 

could be in another part of the document, not in the
 

evaluation criteria -­

DR. MELIUS: Right.
 

DR. ZIEMER: -- we're not evaluating them on
 

that.
 

MR. GRIFFON: Agreed. Agreed.
 

DR. NETON: It might be the case, though,
 

that someone would not want to have their conflict
 

of interest plan public, and in which case they
 

could be docked under this criteria.
 

DR. ZIEMER: Good point, but we're not
 
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399 

leaving that as an option, are we?
 

DR. NETON: No. 


MR. GRIFFON: Right. That's why it may 


be -­

DR. NETON: We could put it in both places,
 

I suppose.
 

MR. GRIFFON: Maybe it can be -- yeah, I
 

don't object to it being moved to the main body or
 

something like that.
 

DR. ZIEMER: I think we can leave it in here
 

now, but I'm just saying it's -- we're not
 

evaluating per se on that basis.
 

MR. GRIFFON: Yeah.
 

The next paragraph was the former paragraph
 

E-5. I think that's very close to the original
 

language, except that NIOSH and ORAU are removed
 

from that because that's a hard-line at the front of
 

the document now, the NIOSH and ORAU -­

DR. ZIEMER: They're already -­

MR. GRIFFON: Right. That's a hard-line, so
 

you don't lose -- right. 


The next paragraph is from the original
 

document, paragraph E-6, it's the other half -­

remember I said E-6 was split in two pieces -- this
 

is the other section, not related to NIOSH and ORAU,
 
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400 

but related to DOE and AWE, and this allows that
 

they can pursue other radiation-related work with
 

DOE or DOE contractors, but they should demonstrate
 

how this will not affect their performance on this
 

contract, and their potential conflicts related to
 

this contract.
 

DR. ZIEMER: Mark, let me back you up one
 

minute. That paragraph we just covered is talking
 

about past work, I think, and the -- the hard-line
 

elimination in 1, 2, and 3 at the front of the
 

document, I believe only refers to current work with
 

ORAU and its team partners. Doesn't this paragraph
 

refer to past work with DOE, AWE, and therefore
 

could also include ORAU and the team partners?
 

MR. GRIFFON: I think you're right. I 


think -­

DR. ZIEMER: It seems to me the original
 

document which included them was probably correct.
 

MR. GRIFFON: Yeah, I might have over edited
 

here. I think you're right.
 

DR. ZIEMER: As I look at those two side-byside, I'm suggesting that we put the words back to
 

the way they were in the original document, which
 

includes both NIOSH and ORAU, ORAU teaming partners
 

because it's -- it's talking about past, not current
 
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401 

activities. Am I correct on that?
 

MR. GRIFFON: The only thing I reflect on is
 

it's talking about -­

DR. ZIEMER: It says at any time in the
 

past. 


MR. GRIFFON: -- it's talking about will not
 

perform reviews related to that site. And NIOSH and
 

ORAU are not sites, right? Maybe that's why I
 

edited it. I think that's why we changed it. I'm
 

doing this on the fly here, too.
 

DR. NETON: This is just related reviews -­

MR. GRIFFON: Right.
 

DR. NETON: -- conflict -- conflicted at
 

that site.
 

MR. GRIFFON: So it's similar to ORAU's
 

policy where they, anyone from their team who worked
 

-- formerly worked at a site will not be involved in
 

the -- will not be the reviewer on that, on those
 

sites. So I think the new version is more correct.
 

DR. NETON: I think so.
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: So in that case, ORAU personnel
 

could have been a DOE contractor at a site and
 

that's what it covers in here.
 

DR. NETON: Right.
 
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402 

MR. GRIFFON: Yeah. Yeah.
 

So the next -- the next paragraph was -- was
 

the other half of E-6 in the old document. And this
 

allows just what I said before -- I know this gets
 

confusing because we jump around -- this allows for
 

bidders to also pursue other work with DOE, but they
 

should explain in the plan how this is not going to
 

affect their performance on this contract, or their
 

independence. 


MR. DeHART: Mark, would you read the first
 

few words of the first -- of that paragraph so I
 

make sure I'm in the right spot?
 

MR. GRIFFON: Yeah. E-6 is -- it starts off
 

with: The offeror, teaming partners -­

MR. DeHART: Yeah, teaming partners.
 

MR. GRIFFON: -- and key personnel.
 

MR. DeHART: Now, where are you reading
 

right now, the same line, right below work history? 


MR. ELLIOTT: You're talking about the new
 

document?
 

MR. DeHART: On the new document.
 

MR. GRIFFON: Oh, in the new document. It's
 

the third paragraph under Conflict of Interest Plan.
 

MR. DeHART: Okay. I see.
 

DR. ZIEMER: In addition, it says.
 
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403 

MR. DeHART: Yeah, I've got it.
 

MR. GRIFFON: All right. The Work History,
 

the first paragraph in the new document, relates
 

back to Paragraph E-2 in the original document. And
 

again, the key here is that, you know, we had the
 

hard-line test in the original document where if
 

they have worked in the past two years at all, they
 

were excluded, and now we -- we rephrase that down
 

halfway, about halfway through the paragraph it
 

says: Greater emphasis will be placed on work
 

experience within the past two years, including
 

current contract relationships. 


So we're -- we're considering it and it's
 

going to be part of the review and the evaluation
 

scheme, but they're not excluded if they worked with
 

them in the past two years. 


And the next paragraph -­

DR. ZIEMER: Mark, I'd like to ask a
 

question. As I looked at the words here, in the old
 

document you talked about the needs justification;
 

in this one we talked about a justification. It did
 

not occur to me, is there a difference, or is that
 

the same thing? Is there such a thing? Do the
 

words mean anything different, that's all I'm
 

asking, "needs justification"?
 
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404 

MR. GRIFFON: I didn't think so. I thought
 

justification just was more accurate. 


DR. ZIEMER: It's certainly encompassing. 


MR. GRIFFON: Yeah.
 

DR. ZIEMER: I wasn't sure. Okay. I'm
 

happy with that. I just wanted to make sure.
 

MR. GRIFFON: The next paragraph is from the
 

original document Paragraph E-3, and this does
 

similar -- it does a similar thing for previous work
 

with NIOSH and ORAU, stating that a greater emphasis
 

will be placed on the last two -- experience within
 

the past two years, the same kind of criteria, but
 

that there's no exclusion -- excuse me, there's no
 

exclusion principle. 


And then the last item there, key personnel. 


This whole -- the last two paragraphs here came from
 

the original document in Paragraph E-9, and you'll
 

see that I -- I stripped out the bigger portion of
 

this paragraph and put a header on it saying: 


Limitations on Changing Key Personnel, moved to the
 

body of the contract. That was sort of a question
 

for us to consider, similar to the point that Paul
 

just raised. All of that paragraph there is
 

important, but we don't think it's really criteria
 

which we can evaluate against. It's the limitations
 
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405 

going forward for the bidder that they should be
 

aware of about changing personnel.
 

DR. ZIEMER: So that might be moved to a
 

different part of the contract -­

MR. GRIFFON: Right.
 

DR. ZIEMER: -- as an information item.
 

MR. GRIFFON: And I think Larry -- if I'm
 

not wrong, I think Larry said that that possibly
 

could be added to the body of the -- the task order
 

contract.
 

DR. NETON: Could you define what you mean
 

by diversion, you just mean change of personnel, or
 

replacement of personnel? That sounds -­

MR. GRIFFON: Where?
 

DR. NETON: At the second sentence: No
 

diversion shall be made by the contractor, blah,
 

blah, blah.
 

MR. GRIFFON: I don't know. I thought this
 

-- I actually thought we lifted this language from
 

the ORAU/NIOSH agreement. Maybe I -- maybe I edited
 

it.
 

DR. MELIUS: It sounds like contracting
 

language.
 

MS. ROESSLER: It sure does. I don't
 

understand -­
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406 

MS. MUNN: Yeah, whatever that means.
 

MR. GRIFFON: Yeah, I rarely use the words
 

ratify too, so.
 

DR. NETON: Yeah.
 

DR. ZIEMER: If it's agreeable, something
 

like that, or we think we are following contract
 

language, if it's the wrong words maybe we could
 

allow the freedom to edit that.
 

MR. ELLIOTT: The contracting officer would
 

be the one to move this to the right place in the
 

body of the RFP, and evaluate that language as to is
 

it saying the right thing according to the FAR, so.
 

DR. ZIEMER: Mark, could I ask you now to
 

move the adoption of these changes, and then we'll
 

get it on the floor.
 

MR. GRIFFON: Okay. Yeah, I'd like to make
 

a motion that we move to accept these amendments of
 

Attachment A.
 

DR. ZIEMER: Seconded?
 

MS. ROESSLER: I second.
 

MR. DeHART: Second.
 

WRITER/EDITOR: I'm sorry. Who seconded?
 

DR. ZIEMER: Gen, or -­

MS. ROESSLER: I'd like to second it.
 

DR. ZIEMER: We have two seconds here. 

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407 

MS. ROESSLER: Roy likes to second it, too.
 

DR. ZIEMER: Now we'll open the floor for
 

discussion. I did commit to Mike Gibson, who had to
 

leave, to relay to the group that Mike has reviewed
 

this and he is in agreement with the proposed
 

changes, and I told him I would pass that along to
 

the Board.
 

Okay. Other comments? Yeah, Jim.
 

DR. MELIUS: I would just, again, probably
 

going back to our last meeting, speak certainly in
 

favor of these. I think that it's sort of
 

recognizing that people may have what we call minor
 

relationships, and I think someone used the example
 

the lectureship, or being paid for a lectureship
 

through ORAU, or a travel contract, or something
 

like travel arrangements or something like that,
 

similar arrangements I can imagine with NIOSH and so
 

forth, so it certainly would open it up and I think
 

be much fairer in that way. There's, I guess a
 

certain amount of risk involved in a sense that it
 

would allow more balancing this versus technical
 

qualifications, and -- but I think that risk is
 

worth -- worth taking if it will help us to get a
 

better pool of bidders for this process.
 

DR. ZIEMER: It certainly makes it more
 
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408 

flexible, does it not?
 

DR. MELIUS: Yeah. 


DR. ZIEMER: Now, we'll have whatever
 

additional discussion is needed. We can -- we can
 

vote on this as a document unless people want to
 

look at specific sections and make changes in what's
 

been proposed, in which case we can go back and -­

and modify, and then complete those modifications,
 

and then adopt the document with whatever additional
 

modifications there may -- so if anyone wishes to
 

address or propose changes to what Mark has
 

presented, this would be the time to do it.
 

I'd like -- is Dave still here? I just want
 

to find out if they had a chance to review this. 


Were there anything that jumped out that sort of -­

the whole document just jumps right out.
 

MR. NAMON: Based on the five minutes we've
 

had to look at it, the only thing that jumped out at
 

me was something that Jim already mentioned, was the
 

word "diversion", which I gathered no one really
 

knows why it's there. But I also gather it means,
 

in this case, it was talking about change in the
 

personnel.
 

DR. ZIEMER: Yeah, we think we know what the
 

intent is there, so if it's not the right word,
 
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409 

well, we'll -­

MR. NAMON: I'm not really in a position to
 

tell you, you know -­

DR. ZIEMER: Or if there was anything that
 

jumped out because I know you had a chance to look
 

through it -- or any of the other staff, who...
 

The real thrust of the changes -- the real
 

thrust is the issue of the two years.
 

MR. GRIFFON: (Nods head affirmatively.)
 

DR. ZIEMER: That's sort of the bottom line,
 

going from the sharp-line two years to the flexible
 

two years.
 

MR. NAMON: There was one more question,
 

which is under the first paragraph under Conflict of
 

Interest plan. 


DR. ZIEMER: In the new document?
 

MR. NAMON: In the new document. The second
 

sentence: This includes, but is not limited to, a
 

detailed current and past history of the offerors
 

contracts and financial relationships. 


And the financial relationships seems to be
 

the new concept that wasn't in the previous
 

document. I didn't know what the thinking was
 

there.
 

DR. ZIEMER: Mark -­
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410 

MR. GRIFFON: That's -- yeah.
 

DR. ZIEMER: -- can you clarify that?
 

MR. GRIFFON: New language, just thought it
 

was more comprehensive. That's true, that is the
 

new language.
 

DR. ZIEMER: And again, I suppose that if
 

there is some sort of legal limitation contractually
 

that doesn't allow collection of certain kinds of
 

financial information, obviously that could be
 

reworded, right?
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: This is sort of an intent at
 

this point?
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: Larry.
 

MR. ELLIOTT: I'd rely on Martha to correct
 

me if I'm out of bounds here, but there is -- the
 

evaluation panel will deal with this, but the
 

contracting officer and their group will deal with
 

the review of past performance and government
 

performance, and a review of financial stature, I
 

guess, is the term. Is that correct, Martha?
 

MS. DiMUZIO: (Nods head affirmatively.)
 

MR. ELLIOTT: Yeah. So the evaluation panel
 

won't review financial documentation, but the
 
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411 

contracting officers do that.
 

DR. ZIEMER: But it has to be provided,
 

which -­

MR. ELLIOTT: It has to be, yeah, as part of
 

the provision under the RFP.
 

DR. ZIEMER: Thank you.
 

MR. ELLIOTT: Let me also, while I've got
 

the mike here, just go on record to make this
 

comment for the Board's edification. The -- all we
 

can say at this point about the technical evaluation
 

panel, and all the Board can say is that the panel
 

will be made up of government employees and
 

nongovernment folks. We can't talk about the
 

composition of the panel, or who those nongovernment
 

persons would be, so you cannot go away from this
 

table and speak about this. It's off limits. 


DR. ZIEMER: Including any discussions that
 

were held during the executive session -­

MR. ELLIOTT: That's correct.
 

DR. ZIEMER: -- last time.
 

MR. ELLIOTT: Once the award is made, then
 

we will be in a position to speak to the
 

affiliations of the panel members, but not the
 

individual identifications, so we can speak to who
 

served on the panel as far as their affiliations. 

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412 

Does everybody understand? Thank you.
 

DR. ZIEMER: Thank you, Larry. Is there a
 

question on that?
 

MS. MUNN: No. But I have one very minor
 

point. Mark, could we -- could we replace the date
 

on your document as 2/2/03 because I know that two
 

months from now I will have a hard time remembering
 

whether what I have here with draft 1/31 on it came
 

before -­

DR. ZIEMER: Let's call it 2/6/03.
 

DR. MELIUS: Yeah.
 

DR. ZIEMER: So mark your document so you
 

recall this is the document we reviewed today. 


Thanks for that.
 

Is the Board ready to act on the motion
 

before us, which is to adopt this revised language
 

for Attachment A?
 

MS. ROESSLER: Yes.
 

DR. ZIEMER: It appears that you are ready
 

to vote. All in favor, say aye.
 

BOARD MEMBERS: Aye.
 

DR. ZIEMER: Are there any opposed?
 

(No response.)
 

DR. ZIEMER: No. Any abstentions?
 

(No response.)
 
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413 

DR. ZIEMER: Then the record will show that
 

the Board has approved this, and we thank the
 

working group for handling that for us.
 

Are there any other matters to come -- well,
 

let me give one more opportunity. Is there anyone
 

from the general public that wishes to speak? Is
 

there anyone from the general public still here?
 

(No response.)
 

DR. ZIEMER: Are there any items for the
 

good of the order?
 

(No response.)
 

DR. ZIEMER: If not, we stand adjourned.
 

(Whereupon, the above-entitled proceedings
 

were adjourned at 1:51 p.m.)
 

o0o
 
_______________________________________

414 

 

 

C E R T I F I C A T E
 

STATE OF GEORGIA )
 

COUNTY OF FORSYTH )


 I, Debbie G. Williams, Certified Court Reporter in
 

and for the State of Georgia, do hereby certify that the
 

foregoing proceedings were taken down by me; that the
 

foregoing proceedings were reduced to print by me; that
 

the foregoing VOLUME II, consisting of pages 263 through
 

413 represent a true, correct and complete transcript of
 

the proceedings; that I am not a relative, employee,
 

attorney or counsel of any of the parties; that I am not
 

a relative or employee of attorney or counsel for any of
 

said parties; nor am I financially interested in the
 

outcome of the action.
 

This certification is expressly withdrawn and denied
 

upon the disassembly or photocopying of the foregoing
 

transcript of the proceedings or any part thereof,
 

including exhibits, unless said disassembly or
 

photocopying is done by the undersigned certified court
 

reporter, and the signature and original seal is attached
 

thereto.


 This, the 22nd day of February, 2003.
 

DEBBIE G. WILLIAMS
 

CERTIFIED COURT REPORTER, B-2167